MEDICARE: HUBBARD EXEMPTED VILLAGE SD

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)

General Provider Information

NPI Number	:	1619117157
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HUBBARD EXEMPTED VILLAGE SD

Provider Business Mailing Address
First Line	:	150 HALL AVE
Second Line	:
City	:	HUBBARD
State	:	OH
Zip	:	44425-2075
Country	:	US
Telephone Number	:	330-534-1921
Fax Number	:	330-534-0522

Provider Business Practice Location Address
First Line	:	150 HALL AVE
Second Line	:
City	:	HUBBARD
State	:	OH
Zip	:	44425-2075
Country	:	US
Telephone Number	:	330-534-1921
Fax Number	:	330-534-0522

Authorized Official
Title or Position	:	TREASURER/CFO
Name	:	MS. RHONDA L BALDWIN
Credential	:
Telephone Number	:	330-534-1921

Provider Enumeration Date	:	02/24/2009
Last Update Date	:	02/24/2009

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Directions to “HUBBARD EXEMPTED VILLAGE SD ” Practice Location

Language	Start Address	Practice Location

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