MEDICARE: GARRETT-KEYSER-BUTLER COMMUNITY SCHOOL DISTRICT

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)

General Provider Information

NPI Number	:	1053062273
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GARRETT-KEYSER-BUTLER COMMUNITY SCHOOL DISTRICT

Provider Business Mailing Address
First Line	:	801 E HOUSTON ST
Second Line	:
City	:	GARRETT
State	:	IN
Zip	:	46738-1662
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	801 E HOUSTON ST
Second Line	:
City	:	GARRETT
State	:	IN
Zip	:	46738-1662
Country	:	US
Telephone Number	:	260-357-3185
Fax Number	:

Authorized Official
Title or Position	:	SUPERINTENDENT
Name	:	TONYA WEAVER
Credential	:
Telephone Number	:	260-357-3185

Provider Enumeration Date	:	01/11/2022
Last Update Date	:	01/11/2022

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