MEDICARE: MT GREYLOCK REGIONAL 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)		MA

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	:	1437275807
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MT GREYLOCK REGIONAL SCHOOL DISTRICT

Provider Business Mailing Address
First Line	:	174 BRUSH HILL AVE
Second Line	:
City	:	WEST SPRINGFIELD
State	:	MA
Zip	:	01089-1204
Country	:	US
Telephone Number	:	413-735-2237
Fax Number	:	413-735-2270

Provider Business Practice Location Address
First Line	:	1781 COLD SPRING RD
Second Line	:
City	:	WILLIAMSTOWN
State	:	MA
Zip	:	01267-2770
Country	:	US
Telephone Number	:	413-458-9582
Fax Number	:

Authorized Official
Title or Position	:	SUPERINTENDENT
Name	:	WILLIAM TRAVIS
Credential	:
Telephone Number	:	413-458-9582

Provider Enumeration Date	:	03/21/2007
Last Update Date	:	08/22/2020

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