Provider Demographics
NPI:1912328915
Name:BRANDON-EVANSVILLE PUBLIC SCHOOLS
Entity Type:Organization
Organization Name:BRANDON-EVANSVILLE PUBLIC SCHOOLS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:WEST
Authorized Official - Suffix:
Authorized Official - Credentials:SUPERINTENDENT
Authorized Official - Phone:320-524-2263
Mailing Address - Street 1:206 3RD ST E
Mailing Address - Street 2:P.O. BOX 185
Mailing Address - City:BRANDON
Mailing Address - State:MN
Mailing Address - Zip Code:56315-4624
Mailing Address - Country:US
Mailing Address - Phone:320-524-2263
Mailing Address - Fax:320-524-2228
Practice Address - Street 1:206 3RD ST E
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:MN
Practice Address - Zip Code:56315-4624
Practice Address - Country:US
Practice Address - Phone:320-524-2263
Practice Address - Fax:320-524-2228
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-18
Last Update Date:2013-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174H00000XOther Service ProvidersHealth EducatorGroup - Multi-Specialty