MEDICARE: SCHOOL DISTRICT NO 5

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)	0846	MT

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	:	1932397239
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SCHOOL DISTRICT NO 5

Provider Business Mailing Address
First Line	:	P.O. BOX 278
Second Line	:	10 2ND AVE SW
City	:	PARK CITY
State	:	MT
Zip	:	59063-0278
Country	:	US
Telephone Number	:	406-633-2361
Fax Number	:	406-633-2913

Provider Business Practice Location Address
First Line	:	10 2ND AVE. SW
Second Line	:
City	:	PARK CITY
State	:	MT
Zip	:	59063-0278
Country	:	US
Telephone Number	:	406-633-2361
Fax Number	:	406-633-2913

Authorized Official
Title or Position	:	SUPERINTENDENT
Name	:	MR. PATRICK AUDET
Credential	:
Telephone Number	:	406-633-2406

Provider Enumeration Date	:	10/11/2007
Last Update Date	:	02/20/2013

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Directions to “SCHOOL DISTRICT NO 5 ” Practice Location

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