Healthcare Provider Details

I. General information

NPI: 1659510691
Provider Name (Legal Business Name): ARCANUM-BUTLER LOCAL SCHOOL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/16/2009
Last Update Date: 07/20/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2011 TROJAN AVE
ARCANUM OH
45304
US

IV. Provider business mailing address

2011 TROJAN AVE
ARCANUM OH
45304-1381
US

V. Phone/Fax

Practice location:
  • Phone: 937-692-5175
  • Fax: 937-692-5959
Mailing address:
  • Phone: 937-692-5174
  • Fax: 937-692-5959

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number State

VIII. Authorized Official

Name: BRENDA HALE
Title or Position: TREASURER
Credential:
Phone: 937-692-5174