MEDICARE: MILWAUKEE ACADEMY OF SCIENCE

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	:	1861655052
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MILWAUKEE ACADEMY OF SCIENCE

Provider Business Mailing Address
First Line	:	2000 W KILBOURN AVE
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53233-1625
Country	:	US
Telephone Number	:	414-933-0302
Fax Number	:	414-933-1426

Provider Business Practice Location Address
First Line	:	2000 W KILBOURN AVE
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53233-1625
Country	:	US
Telephone Number	:	414-933-0302
Fax Number	:	414-933-1426

Authorized Official
Title or Position	:	PRESIDENT/CEO
Name	:	MS. JUDITH L MERRYFIELD
Credential	:
Telephone Number	:	414-933-0302

Provider Enumeration Date	:	07/08/2008
Last Update Date	:	07/08/2008

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