MEDICARE: KING CITY R-I SCHOOLS

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	:	1497951339
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KING CITY R-I SCHOOLS

Provider Business Mailing Address
First Line	:	PO BOX 189
Second Line	:
City	:	KING CITY
State	:	MO
Zip	:	64463-0189
Country	:	US
Telephone Number	:	660-535-4319
Fax Number	:	660-535-4765

Provider Business Practice Location Address
First Line	:	300 NORTH GRAND AVE.
Second Line	:
City	:	KING CITY
State	:	MO
Zip	:	64463-0189
Country	:	US
Telephone Number	:	660-535-4319
Fax Number	:	660-535-4765

Authorized Official
Title or Position	:	SUPERINTENDENT
Name	:	KENDALL EBERSOLD
Credential	:
Telephone Number	:	660-535-4319

Provider Enumeration Date	:	06/26/2007
Last Update Date	:	06/27/2008

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Directions to “KING CITY R-I SCHOOLS ” Practice Location

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