MEDICARE: EDEN CENTRAL SCHOOL DISTRICT

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)

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	:	1346381019
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EDEN CENTRAL SCHOOL DISTRICT

Provider Business Mailing Address
First Line	:	3150 SCHOOLVIEW RD
Second Line	:
City	:	EDEN
State	:	NY
Zip	:	14057-1107
Country	:	US
Telephone Number	:	716-992-3606
Fax Number	:	716-992-3656

Provider Business Practice Location Address
First Line	:	3150 SCHOOLVIEW RD
Second Line	:
City	:	EDEN
State	:	NY
Zip	:	14057-1107
Country	:	US
Telephone Number	:	716-992-3606
Fax Number	:	716-992-3656

Authorized Official
Title or Position	:	SCHOOL ADMINISTRATOR.DIRECTOR OF PU
Name	:	MRS. SHAWN IONE JOHNSON
Credential	:
Telephone Number	:	716-992-3645

Provider Enumeration Date	:	02/08/2007
Last Update Date	:	04/20/2015

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Directions to “EDEN CENTRAL SCHOOL DISTRICT ” Practice Location

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