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NPI Code Detail

MEDICARE: CLARKSVILLE-MONTGOMERY COUNTY SCHOOL SYSTEM

MEDICARE: CLARKSVILLE-MONTGOMERY COUNTY SCHOOL SYSTEM
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
1251300000XLocal Education Agency (LEA)

General Provider Information

NPI Number : 1982039657
Entity Type Code : Organization
Provider Name (Legal Business Name) : CLARKSVILLE-MONTGOMERY COUNTY SCHOOL SYSTEM
Provider Business Mailing Address
First Line : PO BOX 8114
Second Line :
City : CHATTANOOGA
State : TN
Zip : 37414-0114
Country : US
Telephone Number : 423-622-1551
Fax Number : 877-856-7133
Provider Business Practice Location Address
First Line : 621 GRACEY AVE
Second Line :
City : CLARKSVILLE
State : TN
Zip : 37040-4012
Country : US
Telephone Number : 423-622-1551
Fax Number : 877-856-7133
Authorized Official
Title or Position : CREDENTIALING COORDINATOR
Name : CARRIE OLIVER
Credential :
Telephone Number : 423-622-1551
Provider Enumeration Date : 09/12/2013
Last Update Date : 09/12/2013

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Directions to “CLARKSVILLE-MONTGOMERY COUNTY SCHOOL SYSTEM ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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