MEDICARE: CROTHERSVILLE COMMUNITY SCHOOLS

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	:	1861532590
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CROTHERSVILLE COMMUNITY SCHOOLS

Provider Business Mailing Address
First Line	:	201 S. PRESTON
Second Line	:
City	:	CROTHERSVILLE
State	:	IN
Zip	:	47229
Country	:	US
Telephone Number	:	812-793-2601
Fax Number	:	812-793-3004

Provider Business Practice Location Address
First Line	:	201 S. PRESTON
Second Line	:
City	:	CROTHERSVILLE
State	:	IN
Zip	:	47229
Country	:	US
Telephone Number	:	812-793-2601
Fax Number	:	812-793-3004

Authorized Official
Title or Position	:	SUPERINTENDENT
Name	:	TERRY GOODIN
Credential	:
Telephone Number	:	812-793-2601

Provider Enumeration Date	:	02/08/2007
Last Update Date	:	08/22/2020

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