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General NPI Number Information
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NPI Number | 1780953257
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Entity Type | Organization
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Legal Business Name | INDIAN RIVER CENTRAL SCHOOL
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Dates
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Enumeration Date | 12/29/2011
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Last Update Date | 12/29/2011
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Provider Practice Location Address
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Address Line | 8442 S MAIN STREET
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City | EVANS MILLS
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State | NY
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Zip | 13637
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Country | US
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Telephone | 315-629-4331
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Fax | 315-629-5257
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Provider Business Mailing Address
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Address Line | 8442 S MAIN STREET EVANS MILLS PRIMARY SCHOOL
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City | EVANS MILLS
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State | NY
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Zip | 13637
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Country | US
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Telephone | 315-629-4331
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Fax | 315-629-5257
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Authorized Official
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Title or Position | SCHOOL NURSE
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Name | MRS. JUDY ANN STOFFEL
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Credential | REGISTERED NURSE
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Telephone | 315-629-4331
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251300000X
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Taxonomy Name | Local Education Agency (LEA)
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License Number | 305177.1
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License Number State | NY
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