MEDICARE: RED CREEK CENTRAL SCHOOL

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)	0045081	NY

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	:	1568770790
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RED CREEK CENTRAL SCHOOL

Provider Business Mailing Address
First Line	:	6574 SOUTH ST.
Second Line	:
City	:	RED CREEK
State	:	NY
Zip	:	14551
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6574 SOUTH ST
Second Line	:
City	:	RED CREEK
State	:	NY
Zip	:	13143-9551
Country	:	US
Telephone Number	:	315-754-2081
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR OF SPECIAL EDUCATION
Name	:	MRS. JULIA HERBST
Credential	:
Telephone Number	:	315-754-2081

Provider Enumeration Date	:	09/22/2010
Last Update Date	:	09/22/2010

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