MEDICARE: PORTAGE 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	:	1306892658
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PORTAGE AREA SCHOOL DISTRICT

Provider Business Mailing Address
First Line	:	84 MOUNTAIN AVE
Second Line	:
City	:	PORTAGE
State	:	PA
Zip	:	15946-1809
Country	:	US
Telephone Number	:	814-736-9636
Fax Number	:	814-736-9634

Provider Business Practice Location Address
First Line	:	84 MOUNTAIN AVE
Second Line	:
City	:	PORTAGE
State	:	PA
Zip	:	15946-1809
Country	:	US
Telephone Number	:	814-736-9636
Fax Number	:	814-736-9634

Authorized Official
Title or Position	:	BUSINESS ADMINISTRATOR
Name	:	MR. MICHAEL J KUNKO
Credential	:	CFO
Telephone Number	:	814-736-9636

Provider Enumeration Date	:	05/26/2006
Last Update Date	:	08/22/2020

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Directions to “PORTAGE AREA SCHOOL DISTRICT ” Practice Location

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