Organization
ROSWELL INDEPENDENT SCHOOL DISTRICT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GEORGIE DALTON (MEDICAID PROGRAM SPECIALIST)
(505) 627-2543
Entity
Organization
Contact information
Practice address
300 N KENTUCKY AVE, ROSWELL, NM 88201-4636
(505) 627-2543
(505) 627-2544
Mailing address
300 N KENTUCKY AVE, ROSWELL, NM 88201-4636
(505) 627-2543
(505) 627-2544
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Z7697
—
NM
Enumeration date
01/12/2007
Last updated
08/22/2020
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