Provider Demographics
NPI:1831374552
Name:CLAYSBURG-KIMMEL SCHOOL DISTRICT
Entity type:Organization
Organization Name:CLAYSBURG-KIMMEL SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:R
Authorized Official - Last Name:SMITHMYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-239-5141
Mailing Address - Street 1:552 BEDFORD ST.
Mailing Address - Street 2:
Mailing Address - City:CLAYSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:16625-9702
Mailing Address - Country:US
Mailing Address - Phone:814-239-5141
Mailing Address - Fax:814-239-5896
Practice Address - Street 1:552 BEDFORD ST.
Practice Address - Street 2:
Practice Address - City:CLAYSBURG
Practice Address - State:PA
Practice Address - Zip Code:16625-9702
Practice Address - Country:US
Practice Address - Phone:814-239-5141
Practice Address - Fax:814-239-5896
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-31
Last Update Date:2007-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1019919410001Medicaid