MEDICARE: ST CROIX RIVER EDUCATION 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	:	1730223777
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ST CROIX RIVER EDUCATION DISTRICT

Provider Business Mailing Address
First Line	:	PO BOX 637
Second Line	:
City	:	RUSH CITY
State	:	MN
Zip	:	55069-0637
Country	:	US
Telephone Number	:	320-358-3616
Fax Number	:	320-358-1250

Provider Business Practice Location Address
First Line	:	425 S DANA AVE
Second Line	:
City	:	RUSH CITY
State	:	MN
Zip	:	55069-0637
Country	:	US
Telephone Number	:	320-358-3616
Fax Number	:	320-358-1250

Authorized Official
Title or Position	:	EDUCATION DISTRICT DIRECTOR
Name	:	CHRIS MCHUGH
Credential	:
Telephone Number	:	320-358-3616

Provider Enumeration Date	:	02/15/2007
Last Update Date	:	08/22/2020

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Directions to “ST CROIX RIVER EDUCATION DISTRICT ” Practice Location

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