MEDICARE: SPRING GROVE AREA 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)		PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1144256413
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPRING GROVE AREA SCHOOL DISTRICT

Provider Business Mailing Address
First Line	:	100 E COLLEGE AVE
Second Line	:
City	:	SPRING GROVE
State	:	PA
Zip	:	17362-1200
Country	:	US
Telephone Number	:	717-225-4731
Fax Number	:	717-225-6028

Provider Business Practice Location Address
First Line	:	100 E COLLEGE AVE
Second Line	:
City	:	SPRING GROVE
State	:	PA
Zip	:	17362-1200
Country	:	US
Telephone Number	:	717-225-4731
Fax Number	:	717-225-6028

Authorized Official
Title or Position	:	DIRECTOR OF PUPIL SERVICES
Name	:	MS. DONNA M HAKE
Credential	:
Telephone Number	:	717-225-4731

Provider Enumeration Date	:	06/25/2006
Last Update Date	:	08/22/2020

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