MEDICARE: MIDWESTERN INTERMEDIATE UNIT

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)		PA

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	:	1508824327
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MIDWESTERN INTERMEDIATE UNIT

Provider Business Mailing Address
First Line	:	453 MAPLE ST
Second Line	:
City	:	GROVE CITY
State	:	PA
Zip	:	16127-2324
Country	:	US
Telephone Number	:	724-458-6700
Fax Number	:	724-458-5083

Provider Business Practice Location Address
First Line	:	453 MAPLE ST
Second Line	:
City	:	GROVE CITY
State	:	PA
Zip	:	16127-2324
Country	:	US
Telephone Number	:	724-458-6700
Fax Number	:	724-458-5083

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MR. ANGELO PEZZUOLO
Credential	:
Telephone Number	:	724-458-6700

Provider Enumeration Date	:	05/02/2006
Last Update Date	:	08/22/2020

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Directions to “MIDWESTERN INTERMEDIATE UNIT ” Practice Location

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