Healthcare Provider Details

I. General information

NPI: 1053550988
Provider Name (Legal Business Name): GOSHEN LOCAL SCHOOL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/17/2009
Last Update Date: 02/17/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6694 GOSHEN RD
GOSHEN OH
45122-9273
US

IV. Provider business mailing address

6694 GOSHEN RD
GOSHEN OH
45122-9273
US

V. Phone/Fax

Practice location:
  • Phone: 513-722-2222
  • Fax:
Mailing address:
  • Phone: 513-722-2222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number046342
License Number StateOH

VIII. Authorized Official

Name: MR. TODD P SHINKLE
Title or Position: TREASURER
Credential:
Phone: 513-722-2222