MEDICARE: MATH, CIVICS, SCIENCE CHARTER 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)		PR

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	:	1619135381
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MATH, CIVICS, SCIENCE CHARTER SCHOOL

Provider Business Mailing Address
First Line	:	1326 BUTTONWOOD ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19123-3610
Country	:	US
Telephone Number	:	215-923-4880
Fax Number	:

Provider Business Practice Location Address
First Line	:	1326 BUTTONWOOD ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19123-3610
Country	:	US
Telephone Number	:	215-923-4880
Fax Number	:

Authorized Official
Title or Position	:	CHIEF ADMINISTRATIVE OFFICER
Name	:	VERONICA JOYNER
Credential	:
Telephone Number	:	215-923-4880

Provider Enumeration Date	:	05/29/2008
Last Update Date	:	05/29/2008

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