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NPI Code Detail

MEDICARE: WRIGHT STATE UNIVERSITY.

MEDICARE: WRIGHT STATE UNIVERSITY.
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
1251B00000XCase Management Agency0464OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1790731388
Entity Type Code : Organization
Provider Name (Legal Business Name) : WRIGHT STATE UNIVERSITY.
Provider Business Mailing Address
First Line : 6 S PATTERSON BLVD
Second Line :
City : DAYTON
State : OH
Zip : 45402-2111
Country : US
Telephone Number : 937-222-2400
Fax Number : 937-222-7522
Provider Business Practice Location Address
First Line : 1628 SPRINGFIELD ST
Second Line :
City : DAYTON
State : OH
Zip : 45403-1430
Country : US
Telephone Number : 937-222-2400
Fax Number : 937-222-7522
Authorized Official
Title or Position : PROGRAM DIRECTOR
Name : MS. KRISTEN K. DUNN
Credential : PCC, LICDC
Telephone Number : 937-222-2400
Provider Enumeration Date : 05/25/2006
Last Update Date : 09/09/2009

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Directions to “WRIGHT STATE UNIVERSITY. ” Practice Location

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