MEDICARE: JUNCTION CITY SCHOOL

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	163W00000X	Registered Nurse
2	251300000X	Local Education Agency (LEA)	25130000X-LEA	AR

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	:	1861569519
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JUNCTION CITY SCHOOL

Provider Business Mailing Address
First Line	:	PO BOX 790
Second Line	:	100 WEST HOLLY
City	:	JUNCTION CITY
State	:	AR
Zip	:	71749-0790
Country	:	US
Telephone Number	:	870-924-4575
Fax Number	:	870-924-4565

Provider Business Practice Location Address
First Line	:	100 WEST HOLLY
Second Line	:
City	:	JUNCTION CITY
State	:	AR
Zip	:	71749-0790
Country	:	US
Telephone Number	:	870-924-4575
Fax Number	:	870-924-4565

Authorized Official
Title or Position	:	SUPERINTENDENT
Name	:	MR. GARY WAYMAN
Credential	:
Telephone Number	:	870-924-4575

Provider Enumeration Date	:	11/29/2006
Last Update Date	:	04/14/2008

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Directions to “JUNCTION CITY SCHOOL ” Practice Location

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