MEDICARE: BEMENT COMMUNITY UNIT 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)

General Provider Information

NPI Number	:	1134304678
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEMENT COMMUNITY UNIT SCHOOL

Provider Business Mailing Address
First Line	:	201 S CHAMPAIGN ST
Second Line	:
City	:	BEMENT
State	:	IL
Zip	:	61813-1512
Country	:	US
Telephone Number	:	217-678-4200
Fax Number	:

Provider Business Practice Location Address
First Line	:	201 S CHAMPAIGN ST
Second Line	:
City	:	BEMENT
State	:	IL
Zip	:	61813-1512
Country	:	US
Telephone Number	:	217-678-4200
Fax Number	:

Authorized Official
Title or Position	:	SUPERINTENDENT
Name	:	DR. DARRELL STEVENS
Credential	:
Telephone Number	:	217-678-4200

Provider Enumeration Date	:	01/03/2008
Last Update Date	:	04/20/2008

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Directions to “BEMENT COMMUNITY UNIT SCHOOL ” Practice Location

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