=====================================================
General NPI Number Information
=====================================================
NPI Number | 1518170117
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | AVON COMMUNITY SCHOOL CORPORATION
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/08/2007
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7203 E US HIGHWAY 36
-----------------------------------------------------
City | AVON
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 46123-7967
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 317-272-2920
-----------------------------------------------------
Fax | 317-272-1704
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7203 E US HIGHWAY 36
-----------------------------------------------------
City | AVON
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 46123-7967
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 317-272-2920
-----------------------------------------------------
Fax | 317-272-1704
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR OF SPECIAL EDUCATION
-----------------------------------------------------
Name | MRS. CYNTHIA ANNE PITTMAN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 317-272-3190
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251300000X
-----------------------------------------------------
Taxonomy Name | Local Education Agency (LEA)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | IN
-----------------------------------------------------