Provider Demographics
NPI:1679970644
Name:CULVER COMM SCH CORP
Entity type:Organization
Organization Name:CULVER COMM SCH CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCOUNT MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:P
Authorized Official - Last Name:NEVELLS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-260-2544
Mailing Address - Street 1:700 SCHOOL ST
Mailing Address - Street 2:
Mailing Address - City:CULVER
Mailing Address - State:IN
Mailing Address - Zip Code:46511-1027
Mailing Address - Country:US
Mailing Address - Phone:800-260-2544
Mailing Address - Fax:
Practice Address - Street 1:700 SCHOOL ST
Practice Address - Street 2:
Practice Address - City:CULVER
Practice Address - State:IN
Practice Address - Zip Code:46511-1027
Practice Address - Country:US
Practice Address - Phone:800-260-2544
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-19
Last Update Date:2014-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service