MEDICARE: MILFORD COMMUNITY CONSOLDIATED SCHOOL DIST. # 280

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	:	1669701199
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MILFORD COMMUNITY CONSOLDIATED SCHOOL DIST. # 280

Provider Business Mailing Address
First Line	:	PO BOX 302
Second Line	:
City	:	MILFORD
State	:	IL
Zip	:	60953-0302
Country	:	US
Telephone Number	:	815-889-5176
Fax Number	:	815-889-5221

Provider Business Practice Location Address
First Line	:	208 S CHICAGO ST
Second Line	:
City	:	MILFORD
State	:	IL
Zip	:	60953-1234
Country	:	US
Telephone Number	:	815-889-5176
Fax Number	:	815-889-5221

Authorized Official
Title or Position	:	SUPERINTENDENT
Name	:	DR. DALE KENT HASTINGS
Credential	:	DR. IN ED. LEADERSHI
Telephone Number	:	815-889-5176

Provider Enumeration Date	:	12/11/2009
Last Update Date	:	12/11/2009

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