MEDICARE: BURGETTSTOWN 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

General Provider Information

NPI Number	:	1689648701
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BURGETTSTOWN AREA SCHOOL DISTRICT

Provider Business Mailing Address
First Line	:	100 BAVINGTON RD
Second Line	:
City	:	BURGETTSTOWN
State	:	PA
Zip	:	15021-2727
Country	:	US
Telephone Number	:	724-947-8136
Fax Number	:	724-947-8143

Provider Business Practice Location Address
First Line	:	100 BAVINGTON RD
Second Line	:
City	:	BURGETTSTOWN
State	:	PA
Zip	:	15021-2727
Country	:	US
Telephone Number	:	724-947-8136
Fax Number	:	724-947-8143

Authorized Official
Title or Position	:	SUPERINTENDENT
Name	:	MRS. DEBORAH MAUREEN JACKSON
Credential	:
Telephone Number	:	724-947-8136

Provider Enumeration Date	:	02/15/2006
Last Update Date	:	12/10/2007

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