MEDICARE: ELMWOOD BOARD OF EDUCATION

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)

General Provider Information

NPI Number	:	1538399951
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELMWOOD BOARD OF EDUCATION

Provider Business Mailing Address
First Line	:	7650 JERRY CITY RD
Second Line	:
City	:	BLOOMDALE
State	:	OH
Zip	:	44817-9763
Country	:	US
Telephone Number	:	419-655-2583
Fax Number	:	419-655-3995

Provider Business Practice Location Address
First Line	:	7650 JERRY CITY RD
Second Line	:
City	:	BLOOMDALE
State	:	OH
Zip	:	44817-9763
Country	:	US
Telephone Number	:	419-655-2583
Fax Number	:	419-655-3995

Authorized Official
Title or Position	:	SUPERINTENDENT
Name	:	MR. STEVEN PRITTS
Credential	:
Telephone Number	:	419-655-2583

Provider Enumeration Date	:	07/20/2009
Last Update Date	:	07/20/2009

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Directions to “ELMWOOD BOARD OF EDUCATION ” Practice Location

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