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NPI Code Detail

MEDICARE: SUMMIT ACADEMY SECONDARY SCHOOL CANTON

MEDICARE: SUMMIT ACADEMY SECONDARY SCHOOL CANTON
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)

General Provider Information

NPI Number : 1942493788
Entity Type Code : Organization
Provider Name (Legal Business Name) : SUMMIT ACADEMY SECONDARY SCHOOL CANTON
Provider Business Mailing Address
First Line : 1111 W MARKET ST
Second Line :
City : AKRON
State : OH
Zip : 44313-7122
Country : US
Telephone Number : 330-836-6200
Fax Number : 330-836-8216
Provider Business Practice Location Address
First Line : 2400 CLEVELAND AVE NW
Second Line :
City : CANTON
State : OH
Zip : 44709-3613
Country : US
Telephone Number : 330-453-8547
Fax Number : 330-453-8924
Authorized Official
Title or Position : CFO
Name : MR. GERALD P HOLZAPFEL
Credential :
Telephone Number : 330-836-6200
Provider Enumeration Date : 08/24/2007
Last Update Date : 08/24/2007

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Directions to “SUMMIT ACADEMY SECONDARY SCHOOL CANTON ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.