Healthcare Provider Details

I. General information

NPI: 1679706642
Provider Name (Legal Business Name): PARKWAY LOCAL SCHOOLS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2009
Last Update Date: 08/25/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 BUCKEYE ST
ROCKFORD OH
45882-9267
US

IV. Provider business mailing address

400 BUCKEYE ST
ROCKFORD OH
45882-9267
US

V. Phone/Fax

Practice location:
  • Phone: 419-363-3045
  • Fax: 419-363-2595
Mailing address:
  • Phone: 419-363-3045
  • Fax: 419-363-2595

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. GREGORY L. PUTHOFF
Title or Position: SUPERINTENDENT
Credential:
Phone: 419-363-3045