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NPI Code Detail

MEDICARE: MARYVILLE R-II

MEDICARE: MARYVILLE R-II
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)MO

General Provider Information

NPI Number : 1992857254
Entity Type Code : Organization
Provider Name (Legal Business Name) : MARYVILLE R-II
Provider Business Mailing Address
First Line : 1429 SOUTH MUNN AVENUE
Second Line :
City : MARYVILLE
State : MO
Zip : 64468-2756
Country : US
Telephone Number : 660-562-3255
Fax Number : 660-562-4113
Provider Business Practice Location Address
First Line : 1429 SOUTH MUNN AVENUE
Second Line :
City : MARYVILLE
State : MO
Zip : 64468-2756
Country : US
Telephone Number : 660-562-3255
Fax Number : 660-562-4113
Authorized Official
Title or Position : SUPERINTENDENT
Name : DR. VICKIE MILLER
Credential :
Telephone Number : 660-562-3255
Provider Enumeration Date : 01/17/2007
Last Update Date : 08/22/2020

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Directions to “MARYVILLE R-II ” Practice Location

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