MEDICARE: DECATUR COUNTY BOARD OF EDUCATION

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	:	1306916648
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DECATUR COUNTY BOARD OF EDUCATION

Provider Business Mailing Address
First Line	:	100 S WEST ST
Second Line	:
City	:	BAINBRIDGE
State	:	GA
Zip	:	39817-3680
Country	:	US
Telephone Number	:	229-248-2837
Fax Number	:	229-248-2844

Provider Business Practice Location Address
First Line	:	100 S WEST ST
Second Line	:
City	:	BAINBRIDGE
State	:	GA
Zip	:	39817-3680
Country	:	US
Telephone Number	:	229-248-2837
Fax Number	:	229-248-2844

Authorized Official
Title or Position	:	CFO
Name	:	MR. TIM MATTHEWS
Credential	:
Telephone Number	:	229-248-2837

Provider Enumeration Date	:	11/08/2006
Last Update Date	:	08/22/2020

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Directions to “DECATUR COUNTY BOARD OF EDUCATION ” Practice Location

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