MEDICARE: RIDGEWAY COMMUNITY 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	:	1275656829
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RIDGEWAY COMMUNITY SCHOOL

Provider Business Mailing Address
First Line	:	35564 COUNTY ROAD 12
Second Line	:
City	:	HOUSTON
State	:	MN
Zip	:	55943-4006
Country	:	US
Telephone Number	:	507-894-4525
Fax Number	:	507-894-4543

Provider Business Practice Location Address
First Line	:	35564 COUNTY ROAD 12
Second Line	:
City	:	HOUSTON
State	:	MN
Zip	:	55943-4006
Country	:	US
Telephone Number	:	507-894-4525
Fax Number	:	507-894-4543

Authorized Official
Title or Position	:	DIRECTOR OF SPECIAL EDUCATION
Name	:	JOAN BUEHRLE
Credential	:
Telephone Number	:	507-894-4525

Provider Enumeration Date	:	04/09/2007
Last Update Date	:	06/25/2008

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Directions to “RIDGEWAY COMMUNITY SCHOOL ” Practice Location

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