MEDICARE: ATLANTA ISD

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	:	1841333853
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ATLANTA ISD

Provider Business Mailing Address
First Line	:	PO BOX 1146
Second Line	:
City	:	ATLANTA
State	:	TX
Zip	:	75551-1146
Country	:	US
Telephone Number	:	903-796-4194
Fax Number	:

Provider Business Practice Location Address
First Line	:	106 W MAIN ST
Second Line	:
City	:	ATLANTA
State	:	TX
Zip	:	75551-2519
Country	:	US
Telephone Number	:	903-796-4194
Fax Number	:

Authorized Official
Title or Position	:	BUSINESS MANAGER
Name	:	MS. MARILYN COBB
Credential	:
Telephone Number	:	903-796-4194

Provider Enumeration Date	:	02/15/2007
Last Update Date	:	09/29/2008

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Directions to “ATLANTA ISD ” Practice Location

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