MEDICARE: RIVERSIDE LOCAL SCHOOLS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251300000X	Local Education Agency (LEA)		OH

General Provider Information

NPI Number	:	1023254323
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RIVERSIDE LOCAL SCHOOLS

Provider Business Mailing Address
First Line	:	2096 COUNTY ROAD 24 SOUTH
Second Line	:
City	:	DEGRAFF
State	:	OH
Zip	:	43318-2096
Country	:	US
Telephone Number	:	937-585-5981
Fax Number	:	937-585-4599

Provider Business Practice Location Address
First Line	:	2096 COUNTY ROAD 24 S
Second Line	:
City	:	DEGRAFF
State	:	OH
Zip	:	43318-9406
Country	:	US
Telephone Number	:	937-585-5981
Fax Number	:	937-585-4599

Authorized Official
Title or Position	:	SUPERINTENDENT
Name	:	MRS. BERNADETTE PACHMAYER
Credential	:
Telephone Number	:	937-585-5981

Provider Enumeration Date	:	12/17/2008
Last Update Date	:	07/21/2022

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Directions to “RIVERSIDE LOCAL SCHOOLS ” Practice Location

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