MEDICARE: BEAVER RIVER CENTRAL SCHOOL

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)	251300000X	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1114082955
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEAVER RIVER CENTRAL SCHOOL

Provider Business Mailing Address
First Line	:	PO BOX 179
Second Line	:	9508 ARTZ ROAD
City	:	BEAVER FALLS
State	:	NY
Zip	:	13305-0179
Country	:	US
Telephone Number	:	315-346-1211
Fax Number	:	315-346-6775

Provider Business Practice Location Address
First Line	:	9508 ARTZ RD
Second Line	:
City	:	BEAVER FALLS
State	:	NY
Zip	:	13305-0179
Country	:	US
Telephone Number	:	315-346-1211
Fax Number	:	315-346-6775

Authorized Official
Title or Position	:	SCHOOL SUPERINTENDENT
Name	:	LEUEEN SMITHLING
Credential	:
Telephone Number	:	315-346-1211

Provider Enumeration Date	:	12/22/2006
Last Update Date	:	03/19/2015

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