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NPI Code Detail

MEDICARE: MORRIS COUNTY USD 417

MEDICARE: MORRIS COUNTY USD 417
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
1251300000XLocal Education Agency (LEA)

General Provider Information

NPI Number : 1639404809
Entity Type Code : Organization
Provider Name (Legal Business Name) : MORRIS COUNTY USD 417
Provider Business Mailing Address
First Line : 17 WOOD ST
Second Line :
City : COUNCIL GROVE
State : KS
Zip : 66846-1837
Country : US
Telephone Number : 620-767-5192
Fax Number : 620-767-5444
Provider Business Practice Location Address
First Line : 17 WOOD ST
Second Line :
City : COUNCIL GROVE
State : KS
Zip : 66846-1837
Country : US
Telephone Number : 620-767-5192
Fax Number : 620-767-5444
Authorized Official
Title or Position : SUPERINTENDENT
Name : MS. DIANE C MILLER
Credential :
Telephone Number : 620-767-5192
Provider Enumeration Date : 10/06/2009
Last Update Date : 10/06/2009

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