MEDICARE: ST. HENRY CONS. LOCAL SCHOOLS

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	:	1952549370
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ST. HENRY CONS. LOCAL SCHOOLS

Provider Business Mailing Address
First Line	:	391 E. COLUMBUS ST.
Second Line	:
City	:	ST. HENRY
State	:	OH
Zip	:	45883-9574
Country	:	US
Telephone Number	:	419-678-4834
Fax Number	:	419-678-1724

Provider Business Practice Location Address
First Line	:	391 E COLUMBUS ST
Second Line	:
City	:	SAINT HENRY
State	:	OH
Zip	:	45883-8613
Country	:	US
Telephone Number	:	419-678-4834
Fax Number	:	419-678-1724

Authorized Official
Title or Position	:	TREASURER
Name	:	MR. GLENN MILLER
Credential	:
Telephone Number	:	419-678-4834

Provider Enumeration Date	:	01/22/2009
Last Update Date	:	01/22/2009

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