MEDICARE: NORTH COLLEGE HILL CITY SCHOOL DISTRICT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251300000X	Local Education Agency (LEA)	0906685	OH

General Provider Information

NPI Number	:	1417155003
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTH COLLEGE HILL CITY SCHOOL DISTRICT

Provider Business Mailing Address
First Line	:	1731 GOODMAN AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45239-4844
Country	:	US
Telephone Number	:	513-931-8181
Fax Number	:	513-728-4774

Provider Business Practice Location Address
First Line	:	1731 GOODMAN AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45239-4844
Country	:	US
Telephone Number	:	513-931-8181
Fax Number	:	513-728-4774

Authorized Official
Title or Position	:	SUPERINTENDENT
Name	:	MR. GARY GELLERT
Credential	:
Telephone Number	:	513-931-8181

Provider Enumeration Date	:	07/05/2007
Last Update Date	:	06/13/2016

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