Healthcare Provider Details

I. General information

NPI: 1245468693
Provider Name (Legal Business Name): NEWBURY LOCAL SCHOOLS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2009
Last Update Date: 06/24/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14775 AUBURN RD
NEWBURY OH
44065-9702
US

IV. Provider business mailing address

14775 AUBURN RD
NEWBURY OH
44065-9702
US

V. Phone/Fax

Practice location:
  • Phone: 440-564-5501
  • Fax: 440-564-9460
Mailing address:
  • Phone: 440-564-5501
  • Fax: 440-564-9460

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: MR. RICHARD A WAGNER
Title or Position: SUPERINTINDENT
Credential:
Phone: 440-564-5501