MEDICARE: ARCOLA CU 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)

General Provider Information

NPI Number	:	1396838041
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARCOLA CU SCHOOL DISTRICT

Provider Business Mailing Address
First Line	:	351 W WASHINGTON
Second Line	:
City	:	ARCOLA
State	:	IL
Zip	:	61910
Country	:	US
Telephone Number	:	217-268-4962
Fax Number	:

Provider Business Practice Location Address
First Line	:	351 W WASHINGTON
Second Line	:
City	:	ARCOLA
State	:	IL
Zip	:	61910
Country	:	US
Telephone Number	:	217-268-4962
Fax Number	:

Authorized Official
Title or Position	:	SUPERINTENDENT
Name	:	REGGIE CLINTON
Credential	:
Telephone Number	:	217-268-4962

Provider Enumeration Date	:	10/02/2006
Last Update Date	:	08/22/2020

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