MEDICARE: DILLION SCHOOL DISTRICT ONE

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	:	1073688396
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DILLION SCHOOL DISTRICT ONE

Provider Business Mailing Address
First Line	:	PO BOX 644
Second Line	:
City	:	LAKE VIEW
State	:	SC
Zip	:	29563-0644
Country	:	US
Telephone Number	:	843-759-3001
Fax Number	:	843-759-3000

Provider Business Practice Location Address
First Line	:	207 EAST THIRD AVENUE
Second Line	:
City	:	LAKE VIEW
State	:	SC
Zip	:	29563-0644
Country	:	US
Telephone Number	:	843-759-3001
Fax Number	:	843-759-3000

Authorized Official
Title or Position	:	SUPERINTENDENT
Name	:	MR. STEPHEN LAIRD
Credential	:
Telephone Number	:	843-759-3001

Provider Enumeration Date	:	11/21/2006
Last Update Date	:	08/22/2020

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