MEDICARE: GILMORE CITY-BRADGATE COMMUNITY SCHOOL 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	:	1053562363
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GILMORE CITY-BRADGATE COMMUNITY SCHOOL DISTRICT

Provider Business Mailing Address
First Line	:	402 SE E AVE
Second Line	:
City	:	GILMORE CITY
State	:	IA
Zip	:	50541-6072
Country	:	US
Telephone Number	:	515-373-6619
Fax Number	:

Provider Business Practice Location Address
First Line	:	402 SE E AVE
Second Line	:
City	:	GILMORE CITY
State	:	IA
Zip	:	50541-6072
Country	:	US
Telephone Number	:	515-373-6619
Fax Number	:	515-373-6092

Authorized Official
Title or Position	:	BOARD SECRETARY
Name	:	MS. JULIE DICKEY
Credential	:
Telephone Number	:	515-373-6619

Provider Enumeration Date	:	10/06/2008
Last Update Date	:	10/06/2008

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