Healthcare Provider Details

I. General information

NPI: 1912106519
Provider Name (Legal Business Name): THE COLLEGE OF WOOSTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2007
Last Update Date: 07/17/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

570 E. WAYNE AVENUE
WOOSTER OH
44691
US

IV. Provider business mailing address

1101 N BEVER ST
WOOSTER OH
44691
US

V. Phone/Fax

Practice location:
  • Phone: 330-263-2319
  • Fax: 330-263-2369
Mailing address:
  • Phone: 330-263-2319
  • Fax: 330-263-2369

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS1000X
TaxonomyStudent Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. SHEILA WILSON
Title or Position: SECRETARY OF THE COLLEGE
Credential:
Phone: 330-263-2313