Healthcare Provider Details

I. General information

NPI: 1790925121
Provider Name (Legal Business Name): NORTH FORK LOCAL SCHOOL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/25/2009
Last Update Date: 02/25/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

312 MAPLE AVE
UTICA OH
43080-9756
US

IV. Provider business mailing address

312 MAPLE AVE PO BOX 497
UTICA OH
43080-9756
US

V. Phone/Fax

Practice location:
  • Phone: 740-892-2010
  • Fax: 740-892-2937
Mailing address:
  • Phone: 740-892-2010
  • Fax: 740-892-2937

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. JACK A MCDONALD
Title or Position: TREASURER/CFO
Credential:
Phone: 740-892-3897