MEDICARE: SUMTER SCHOOL DISTRICT 17

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	:	1124076641
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUMTER SCHOOL DISTRICT 17

Provider Business Mailing Address
First Line	:	1109 N PIKE W
Second Line	:
City	:	SUMTER
State	:	SC
Zip	:	29153-1954
Country	:	US
Telephone Number	:	803-469-8536
Fax Number	:	803-469-6006

Provider Business Practice Location Address
First Line	:	1109 N PIKE W
Second Line	:
City	:	SUMTER
State	:	SC
Zip	:	29153-1954
Country	:	US
Telephone Number	:	803-469-8536
Fax Number	:	803-469-6006

Authorized Official
Title or Position	:	SUPERINTENDENT
Name	:	DR. ZONA JEFFERSON
Credential	:
Telephone Number	:	803-469-8536

Provider Enumeration Date	:	05/05/2006
Last Update Date	:	08/22/2020

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Directions to “SUMTER SCHOOL DISTRICT 17 ” Practice Location

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