Healthcare Provider Details

I. General information

NPI: 1205989738
Provider Name (Legal Business Name): ROSCOE CENTRAL SCHOOL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/19/2007
Last Update Date: 04/29/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 ACADEMY ST.
ROSCOE NY
12776
US

IV. Provider business mailing address

6 ACADEMY ST. PO BOX 429
ROSCOE NY
12776-0429
US

V. Phone/Fax

Practice location:
  • Phone: 607-498-4126
  • Fax:
Mailing address:
  • Phone: 607-498-4126
  • Fax: 607-498-6015

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number State

VIII. Authorized Official

Name: MR. JOHN EVANS
Title or Position: SUPERINTENDENT
Credential:
Phone: 607-498-4126