MEDICARE: KENTON COUNTY 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	:	1093990582
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KENTON COUNTY SCHOOL DISTRICT

Provider Business Mailing Address
First Line	:	1055 EATON DR
Second Line	:
City	:	FT WRIGHT
State	:	KY
Zip	:	41017-9655
Country	:	US
Telephone Number	:	859-344-8888
Fax Number	:	859-344-1531

Provider Business Practice Location Address
First Line	:	1055 EATON DR
Second Line	:
City	:	FT WRIGHT
State	:	KY
Zip	:	41017-9655
Country	:	US
Telephone Number	:	859-344-8888
Fax Number	:	859-344-1531

Authorized Official
Title or Position	:	SUPERINTENDENT OF SCHOOLS
Name	:	MR. TIM J. HANNER
Credential	:
Telephone Number	:	859-344-8888

Provider Enumeration Date	:	01/03/2008
Last Update Date	:	01/03/2008

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