MEDICARE: RUSH HENRIETTA 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	:	1710279443
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RUSH HENRIETTA CENTRAL SCHOOL DISTRICT

Provider Business Mailing Address
First Line	:	85 SHELL EDGE DR
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14623-4356
Country	:	US
Telephone Number	:	585-359-5413
Fax Number	:	585-359-5423

Provider Business Practice Location Address
First Line	:	85 SHELL EDGE DR
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14623-4356
Country	:	US
Telephone Number	:	585-359-5413
Fax Number	:	585-359-5423

Authorized Official
Title or Position	:	SCHOOL NURSE TEACHER
Name	:	MS. KATHLEEN MARY DONOVAN
Credential	:	R.N.
Telephone Number	:	585-359-5413

Provider Enumeration Date	:	05/13/2011
Last Update Date	:	05/13/2011

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Directions to “RUSH HENRIETTA CENTRAL SCHOOL DISTRICT ” Practice Location

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