MEDICARE: CATOOSA COUNTY PUBLIC 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)		GA

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	:	1205994472
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CATOOSA COUNTY PUBLIC SCHOOLS

Provider Business Mailing Address
First Line	:	307 CLEVELAND ST
Second Line	:
City	:	RINGGOLD
State	:	GA
Zip	:	30736-2057
Country	:	US
Telephone Number	:	706-965-4052
Fax Number	:

Provider Business Practice Location Address
First Line	:	307 CLEVELAND ST
Second Line	:
City	:	RINGGOLD
State	:	GA
Zip	:	30736-2057
Country	:	US
Telephone Number	:	706-965-4052
Fax Number	:

Authorized Official
Title or Position	:	BILLING ADMINISTRATOR
Name	:	JOHN L VASSAR
Credential	:
Telephone Number	:	386-884-9900

Provider Enumeration Date	:	12/04/2006
Last Update Date	:	10/09/2012

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Directions to “CATOOSA COUNTY PUBLIC SCHOOLS ” Practice Location

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