Provider Demographics
NPI:1538375860
Name:CONCORD SCHOOL DISTRICT
Entity type:Organization
Organization Name:CONCORD SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASST. SUPT. OF SCHOOLS
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:PROHL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-225-0811
Mailing Address - Street 1:16 RUMFORD STREET
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301
Mailing Address - Country:US
Mailing Address - Phone:603-225-0811
Mailing Address - Fax:603-226-2187
Practice Address - Street 1:16 RUMFORD ST
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-3949
Practice Address - Country:US
Practice Address - Phone:603-225-0811
Practice Address - Fax:603-226-2187
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH50008000Medicaid