MEDICARE: NORTHERN UNITED CHARTER SCHOOLS

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	:	1134776909
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTHERN UNITED CHARTER SCHOOLS

Provider Business Mailing Address
First Line	:	2120 CAMPTON RD STE H
Second Line	:
City	:	EUREKA
State	:	CA
Zip	:	95503-8209
Country	:	US
Telephone Number	:	707-445-2660
Fax Number	:

Provider Business Practice Location Address
First Line	:	2120 CAMPTON RD STE H
Second Line	:
City	:	EUREKA
State	:	CA
Zip	:	95503-8209
Country	:	US
Telephone Number	:	707-445-2660
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	SHARI LOVETT
Credential	:
Telephone Number	:	707-445-2660

Provider Enumeration Date	:	08/26/2019
Last Update Date	:	08/26/2019

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Directions to “NORTHERN UNITED CHARTER SCHOOLS ” Practice Location

Language	Start Address	Practice Location

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