Organization Name: | TAMAROA S D #5 |
NPI Number: | 1275703191 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | RHONDA C FLEMING (SECRETARY) |
Mailing Address: | 200 West Main Steet Tamaroa |
State: | IL US |
Postal Code: | 62888 |
Phone Number: | 6184965513 |
Fax Number: | 6184963911 |
NPI Enumeration Date: | 03/06/2008 |
NPI Last Update Date: | 04/20/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QS1000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Student Health |
Taxonomy Definition: |