Provider Demographics
NPI:1801946124
Name:ROXBURY CENTRAL SCHOOL
Entity type:Organization
Organization Name:ROXBURY CENTRAL SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:G
Authorized Official - Last Name:CARR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:607-326-4151
Mailing Address - Street 1:53729 STATE HIGHWAY 30
Mailing Address - Street 2:
Mailing Address - City:ROXBURY
Mailing Address - State:NY
Mailing Address - Zip Code:12474-1529
Mailing Address - Country:US
Mailing Address - Phone:607-326-4151
Mailing Address - Fax:607-326-4154
Practice Address - Street 1:53729 STATE HIGHWAY 30
Practice Address - Street 2:
Practice Address - City:ROXBURY
Practice Address - State:NY
Practice Address - Zip Code:12474-1529
Practice Address - Country:US
Practice Address - Phone:607-326-4151
Practice Address - Fax:607-326-4154
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-11
Last Update Date:2007-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01609287Medicaid