MEDICARE: BUCKEYE UNION 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	:	1437417276
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BUCKEYE UNION SCHOOL DISTRICT

Provider Business Mailing Address
First Line	:	4560 BUCKEYE RD
Second Line	:
City	:	SHINGLE SPRINGS
State	:	CA
Zip	:	95682-9511
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4560 BUCKEYE RD
Second Line	:
City	:	SHINGLE SPRINGS
State	:	CA
Zip	:	95682-9511
Country	:	US
Telephone Number	:	530-677-2261
Fax Number	:

Authorized Official
Title or Position	:	CBO
Name	:	MS. NANCY DICKERSON
Credential	:
Telephone Number	:	530-677-2261

Provider Enumeration Date	:	04/30/2012
Last Update Date	:	04/30/2012

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Directions to “BUCKEYE UNION SCHOOL DISTRICT ” Practice Location

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