Provider Demographics
NPI:1801951181
Name:CHENANGO FORKS CENTRAL SCHOOL DISTRICT
Entity type:Organization
Organization Name:CHENANGO FORKS CENTRAL SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT OF SCHOOLS
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:BUNDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:607-648-7543
Mailing Address - Street 1:1 GORDON DR
Mailing Address - Street 2:
Mailing Address - City:BINGHAMTON
Mailing Address - State:NY
Mailing Address - Zip Code:13901-5614
Mailing Address - Country:US
Mailing Address - Phone:607-648-7564
Mailing Address - Fax:607-648-7560
Practice Address - Street 1:6 PATCH RD
Practice Address - Street 2:
Practice Address - City:BINGHAMTON
Practice Address - State:NY
Practice Address - Zip Code:13901-5631
Practice Address - Country:US
Practice Address - Phone:607-648-7580
Practice Address - Fax:607-648-7560
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-27
Last Update Date:2015-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01379331Medicaid