MEDICARE: PINELANDS REGIONAL 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)

General Provider Information

NPI Number	:	1669711057
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PINELANDS REGIONAL SCHOOL DISTRICT

Provider Business Mailing Address
First Line	:	PO BOX 248
Second Line	:	565 NUGENTOWN ROAD
City	:	LITTLE EGG HARBOR
State	:	NJ
Zip	:	08087-0248
Country	:	US
Telephone Number	:	609-296-3106
Fax Number	:	609-857-4114

Provider Business Practice Location Address
First Line	:	565 NUGENTOWN RD
Second Line	:
City	:	LITTLE EGG HARBOR TWP
State	:	NJ
Zip	:	08087-3909
Country	:	US
Telephone Number	:	609-296-3106
Fax Number	:	609-857-4114

Authorized Official
Title or Position	:	DIRECTOR OF SPECIAL EDUCATION
Name	:	ELLEN M WARD
Credential	:
Telephone Number	:	609-296-3106

Provider Enumeration Date	:	02/06/2013
Last Update Date	:	02/06/2013

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