Provider Demographics
NPI:1902930472
Name:TOWN OF MARION
Entity Type:Organization
Organization Name:TOWN OF MARION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT OF SCHOOLS
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:R
Authorized Official - Last Name:COOPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-758-2772
Mailing Address - Street 1:135 MARION RD
Mailing Address - Street 2:
Mailing Address - City:MATTAPOISETT
Mailing Address - State:MA
Mailing Address - Zip Code:02739-1621
Mailing Address - Country:US
Mailing Address - Phone:508-758-2772
Mailing Address - Fax:508-758-2802
Practice Address - Street 1:105 E GROVE ST
Practice Address - Street 2:
Practice Address - City:MIDDLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02346-2743
Practice Address - Country:US
Practice Address - Phone:508-947-3636
Practice Address - Fax:508-946-1088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2008-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1953052Medicaid