MEDICARE: SALEM CITY 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	:	1104066513
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SALEM CITY SCHOOL DISTRICT

Provider Business Mailing Address
First Line	:	1226 E STATE ST
Second Line	:
City	:	SALEM
State	:	OH
Zip	:	44460-2222
Country	:	US
Telephone Number	:	330-332-0316
Fax Number	:	330-332-8936

Provider Business Practice Location Address
First Line	:	1226 E STATE ST
Second Line	:
City	:	SALEM
State	:	OH
Zip	:	44460-2222
Country	:	US
Telephone Number	:	330-332-0316
Fax Number	:	330-332-8936

Authorized Official
Title or Position	:	TREASURER
Name	:	MRS. JILL ANN ROWE
Credential	:
Telephone Number	:	330-332-0316

Provider Enumeration Date	:	02/25/2009
Last Update Date	:	02/25/2009

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Directions to “SALEM CITY SCHOOL DISTRICT ” Practice Location

Language	Start Address	Practice Location

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