MEDICARE: GILBRALTAR AREA 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)		WI

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	:	1770709867
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GILBRALTAR AREA SCHOOL DISTRICT

Provider Business Mailing Address
First Line	:	3924 HIGHWAY 42
Second Line	:
City	:	FISH CREEK
State	:	WI
Zip	:	54212-9755
Country	:	US
Telephone Number	:	920-868-3284
Fax Number	:	920-868-2417

Provider Business Practice Location Address
First Line	:	3924 HIGHWAY 42
Second Line	:
City	:	FISH CREEK
State	:	WI
Zip	:	54212-9755
Country	:	US
Telephone Number	:	920-868-3284
Fax Number	:	920-868-2417

Authorized Official
Title or Position	:	DISTRICT SUPERINTENDENT
Name	:	DR. STEPHEN SEYFER
Credential	:
Telephone Number	:	920-868-3284

Provider Enumeration Date	:	04/17/2007
Last Update Date	:	08/22/2020

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