White Bear Area Senior Progam Isd 624

Primary specialty

Home Delivered MealsTaxonomy code 332U00000X

Legal business name

WHITE BEAR AREA SENIOR PROGAM ISD 624

Practice address

2484 County Road F E
White Bear Lake, MN 55110-7404

Phone

(612) 623-3363

NPI assigned

Feb 19, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Wayne Kazmierczak

Title

Director

Phone

(612) 623-3363

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Ind School Dist 6242 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Ind School Dist 624

  • Local Education Agency (LEA)
  • White Bear Lake, MN
  • NPI 1770649915
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1455840000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455840000000",
    "number": "1134588031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2484 COUNTY ROAD F E",
            "city": "WHITE BEAR LAKE",
            "state": "MN",
            "postal_code": "551107404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2484 COUNTY ROAD F E",
            "city": "WHITE BEAR LAKE",
            "state": "MN",
            "postal_code": "551107404",
            "telephone_number": "612-623-3363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHITE BEAR AREA SENIOR PROGAM ISD 624",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-19",
        "last_updated": "2016-02-19",
        "status": "A",
        "authorized_official_last_name": "KAZMIERCZAK",
        "authorized_official_first_name": "WAYNE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "612-623-3363"
    },
    "taxonomies": [
        {
            "code": "332U00000X",
            "taxonomy_group": "",
            "desc": "Home Delivered Meals",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "A365023500",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Malia Weinhagen
• Nancy Kay Sheely Weirens, L.AC., MS
• Kaya Werner, LADC
• Megan Westerheide, LICSW
• Lea Wetzell, L.N, C.N.S
• White Bear Dentists, PC (White Bear Dentists)
• White Bear Foot and Ankle Clinic Inc
• White Bear Foot and Ankle Clinic, Inc.
• White Bear Foot Clinic Inc
• White Bear Health Mart Pharmacy LLC (White Bear Health Mart)

• Home Delivered Meals in White Bear Lake, MN
• Providers in White Bear Lake, MN by specialty
• Home Delivered Meals in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.