MEDICARE: ANDERSON SCHOOL DISTRICT FOUR

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	:	1942275649
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANDERSON SCHOOL DISTRICT FOUR

Provider Business Mailing Address
First Line	:	315 E QUEEN ST
Second Line	:	PO BOX 545
City	:	PENDLETON
State	:	SC
Zip	:	29670-0545
Country	:	US
Telephone Number	:	864-646-8000
Fax Number	:	864-646-8555

Provider Business Practice Location Address
First Line	:	315 E QUEEN ST
Second Line	:
City	:	PENDLETON
State	:	SC
Zip	:	29670-0545
Country	:	US
Telephone Number	:	864-646-8000
Fax Number	:	864-646-8555

Authorized Official
Title or Position	:	FINANCE DIRECTOR
Name	:	MR. MAURICE K LOPEZ
Credential	:
Telephone Number	:	864-646-8000

Provider Enumeration Date	:	02/17/2006
Last Update Date	:	08/22/2020

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Directions to “ANDERSON SCHOOL DISTRICT FOUR ” Practice Location

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