MEDICARE: ELBA CENTRAL SCHOOL

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)

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	:	1740332477
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELBA CENTRAL SCHOOL

Provider Business Mailing Address
First Line	:	PO BOX 370
Second Line	:	57 SOUTH MAIN ST.
City	:	ELBA
State	:	NY
Zip	:	14058-0370
Country	:	US
Telephone Number	:	585-757-9967
Fax Number	:	585-757-2979

Provider Business Practice Location Address
First Line	:	57 SOUTH MAIN STREET
Second Line	:
City	:	ELBA
State	:	NY
Zip	:	14058-0370
Country	:	US
Telephone Number	:	585-757-9967
Fax Number	:	585-757-2979

Authorized Official
Title or Position	:	CSE CHAIRPERSON
Name	:	MR. DANIEL DEMARE
Credential	:
Telephone Number	:	585-757-9967

Provider Enumeration Date	:	01/16/2007
Last Update Date	:	11/02/2010

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