MEDICARE: ELMORE COUNTY BOARD OF EDUCATION

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	:	1437329075
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELMORE COUNTY BOARD OF EDUCATION

Provider Business Mailing Address
First Line	:	PO BOX 817
Second Line	:
City	:	WETUMPKA
State	:	AL
Zip	:	36092-0014
Country	:	US
Telephone Number	:	334-567-1200
Fax Number	:

Provider Business Practice Location Address
First Line	:	203 HILL ST
Second Line	:
City	:	WETUMPKA
State	:	AL
Zip	:	36092-2722
Country	:	US
Telephone Number	:	334-567-1200
Fax Number	:

Authorized Official
Title or Position	:	SUPERINTENDENT
Name	:	MR. JEFFERY E LANGHAM
Credential	:
Telephone Number	:	334-567-1200

Provider Enumeration Date	:	03/11/2008
Last Update Date	:	03/11/2008

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Directions to “ELMORE COUNTY BOARD OF EDUCATION ” Practice Location

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