Provider Demographics
NPI:1205989738
Name:ROSCOE CENTRAL SCHOOL
Entity type:Organization
Organization Name:ROSCOE CENTRAL SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:607-498-4126
Mailing Address - Street 1:6 ACADEMY ST.
Mailing Address - Street 2:PO BOX 429
Mailing Address - City:ROSCOE
Mailing Address - State:NY
Mailing Address - Zip Code:12776-0429
Mailing Address - Country:US
Mailing Address - Phone:607-498-4126
Mailing Address - Fax:607-498-6015
Practice Address - Street 1:6 ACADEMY ST.
Practice Address - Street 2:
Practice Address - City:ROSCOE
Practice Address - State:NY
Practice Address - Zip Code:12776
Practice Address - Country:US
Practice Address - Phone:607-498-4126
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-19
Last Update Date:2015-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01595862Medicaid