MEDICARE: ROBERTSON 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)		KY

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	:	1700932936
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROBERTSON COUNTY BOARD OF EDUCATION

Provider Business Mailing Address
First Line	:	181 N. MAIN ST.
Second Line	:
City	:	MT. OLIVET
State	:	KY
Zip	:	41064-0168
Country	:	US
Telephone Number	:	606-724-5421
Fax Number	:	606-724-5225

Provider Business Practice Location Address
First Line	:	181 N .MAIN ST.
Second Line	:
City	:	MT. OLIVET
State	:	KY
Zip	:	41064-0168
Country	:	US
Telephone Number	:	606-724-5421
Fax Number	:	606-724-5225

Authorized Official
Title or Position	:	DIRECTOR OF SPECIAL EDUCATION
Name	:	MS. CHRISTY GRAVES
Credential	:
Telephone Number	:	606-724-5421

Provider Enumeration Date	:	01/29/2007
Last Update Date	:	07/01/2008

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Directions to “ROBERTSON COUNTY BOARD OF EDUCATION ” Practice Location

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