Provider Demographics
NPI:1538377098
Name:WEST BRANCH COMMUNITY SCHOOL DISTRICT
Entity type:Organization
Organization Name:WEST BRANCH COMMUNITY SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANGIE
Authorized Official - Middle Name:
Authorized Official - Last Name:WALTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:319-643-7213
Mailing Address - Street 1:PO BOX 637
Mailing Address - Street 2:148 N. OLIPHANT
Mailing Address - City:WEST BRANCH
Mailing Address - State:IA
Mailing Address - Zip Code:52358-0637
Mailing Address - Country:US
Mailing Address - Phone:319-643-7213
Mailing Address - Fax:319-643-7122
Practice Address - Street 1:148 N. OLIPHANT
Practice Address - Street 2:
Practice Address - City:WEST BRANCH
Practice Address - State:IA
Practice Address - Zip Code:52358-0637
Practice Address - Country:US
Practice Address - Phone:319-643-7213
Practice Address - Fax:319-643-7122
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-18
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
IA0419994Medicaid