MEDICARE: SCHOOL DISTRICT OF NEW LONDON

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	:	1477732246
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SCHOOL DISTRICT OF NEW LONDON

Provider Business Mailing Address
First Line	:	901 W WASHINGTON ST
Second Line	:
City	:	NEW LONDON
State	:	WI
Zip	:	54961-1653
Country	:	US
Telephone Number	:	920-982-8530
Fax Number	:	920-982-8551

Provider Business Practice Location Address
First Line	:	901 W WASHINGTON ST
Second Line	:
City	:	NEW LONDON
State	:	WI
Zip	:	54961-1653
Country	:	US
Telephone Number	:	920-982-8530
Fax Number	:	920-982-8551

Authorized Official
Title or Position	:	DISTRICT ADMINISTRATOR
Name	:	MR. WILLIAM FITZPATRICK
Credential	:
Telephone Number	:	920-982-8530

Provider Enumeration Date	:	10/30/2007
Last Update Date	:	10/30/2007

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Directions to “SCHOOL DISTRICT OF NEW LONDON ” Practice Location

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