1508276171 NPI number — CANTON CITY SCHOOL DISTRICT

Table of content: (NPI 1508276171)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1508276171 NPI number — CANTON CITY SCHOOL DISTRICT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CANTON CITY SCHOOL DISTRICT
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1508276171
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/05/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
15703 NORMANDY AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CLEVELAND
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44111-1919
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
440-821-4072
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
305 MCKINLEY AVE NW
Provider Second Line Business Practice Location Address:
SPECIAL EDUCATION DEPARTMENT
Provider Business Practice Location Address City Name:
CANTON
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44702-1717
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
330-438-2550
Provider Business Practice Location Address Fax Number:
330-580-3164
Provider Enumeration Date:
05/05/2014

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
PACK
Authorized Official First Name:
VAL
Authorized Official Middle Name:
Authorized Official Title or Position:
SPECIAL EDUCATION DIRECTOR
Authorized Official Telephone Number:
330-438-2551

Provider Taxonomy Codes

  • Taxonomy code: 251300000X , with the licence number:  OH3083828 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)