Healthcare Provider Details

I. General information

NPI: 1962708123
Provider Name (Legal Business Name): WATERLOO LOCAL SCHOOL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2011
Last Update Date: 02/07/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1464 INDUSTRY RD
ATWATER OH
44201-9349
US

IV. Provider business mailing address

1464 INDUSTRY RD
ATWATER OH
44201-9349
US

V. Phone/Fax

Practice location:
  • Phone: 330-947-2664
  • Fax: 330-947-2847
Mailing address:
  • Phone: 330-947-2664
  • Fax: 330-947-2847

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: DR. ANDREW JAMES HILL
Title or Position: SUPERINTENDENT
Credential:
Phone: 330-947-2664