MEDICARE: WEST FORK 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	:	1124312384
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WEST FORK COMMUNITY SCHOOL DISTRICT

Provider Business Mailing Address
First Line	:	210 2ND ST S
Second Line	:	PO BOX 60
City	:	ROCKWELL
State	:	IA
Zip	:	50469-7704
Country	:	US
Telephone Number	:	641-822-3236
Fax Number	:	641-822-4882

Provider Business Practice Location Address
First Line	:	210 2ND ST S
Second Line	:
City	:	ROCKWELL
State	:	IA
Zip	:	50469-7704
Country	:	US
Telephone Number	:	641-822-3236
Fax Number	:	641-822-4882

Authorized Official
Title or Position	:	SUPERINTENDENT
Name	:	MR. DARRIN STRIKE
Credential	:
Telephone Number	:	641-892-4160

Provider Enumeration Date	:	06/06/2011
Last Update Date	:	06/27/2011

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