MEDICARE: JONATHAN ALDER LOCAL 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)

General Provider Information

NPI Number	:	1821237041
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JONATHAN ALDER LOCAL SCHOOL DISTRICT

Provider Business Mailing Address
First Line	:	9200 US HIGHWAY 42 S
Second Line	:
City	:	PLAIN CITY
State	:	OH
Zip	:	43064-9238
Country	:	US
Telephone Number	:	614-873-8685
Fax Number	:

Provider Business Practice Location Address
First Line	:	9200 US HIGHWAY 42 S
Second Line	:
City	:	PLAIN CITY
State	:	OH
Zip	:	43064-9238
Country	:	US
Telephone Number	:	614-873-8685
Fax Number	:

Authorized Official
Title or Position	:	TREASURER
Name	:	JANIS THOM
Credential	:
Telephone Number	:	614-873-8685

Provider Enumeration Date	:	02/11/2009
Last Update Date	:	02/11/2009

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