Healthcare Provider Details

I. General information

NPI: 1699915181
Provider Name (Legal Business Name): MILLCREEK-WEST UNITY LOCAL SD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/24/2009
Last Update Date: 02/05/2024
Certification Date: 02/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 W JACKSON ST
WEST UNITY OH
43570-9465
US

IV. Provider business mailing address

1401 W JACKSON ST
WEST UNITY OH
43570-9465
US

V. Phone/Fax

Practice location:
  • Phone: 419-924-2365
  • Fax:
Mailing address:
  • Phone: 419-924-2365
  • Fax:

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: TRACI THOMPSON
Title or Position: TREASURER/CFO
Credential:
Phone: 419-924-2365