MEDICARE: EVANS-BRANT CENTRAL 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)

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	:	1578604138
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EVANS-BRANT CENTRAL SCHOOL DISTRICT

Provider Business Mailing Address
First Line	:	959 BEACH ROAD
Second Line	:
City	:	ANGOLA
State	:	NY
Zip	:	14006-9782
Country	:	US
Telephone Number	:	716-926-2221
Fax Number	:	716-549-6228

Provider Business Practice Location Address
First Line	:	959 BEACH ROAD
Second Line	:
City	:	ANGOLA
State	:	NY
Zip	:	14006-9782
Country	:	US
Telephone Number	:	716-926-2221
Fax Number	:	716-549-6228

Authorized Official
Title or Position	:	BUSINESS ADMINISTRATOR
Name	:	DANIEL W. PACOS
Credential	:
Telephone Number	:	716-926-2221

Provider Enumeration Date	:	02/08/2007
Last Update Date	:	03/11/2015

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Directions to “EVANS-BRANT CENTRAL SCHOOL DISTRICT ” Practice Location

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