Provider Demographics
NPI:1003238528
Name:COLUMBUS GROVE LOCAL SCHOOL DISTRICT
Entity Type:Organization
Organization Name:COLUMBUS GROVE LOCAL SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:VERHOFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-659-2639
Mailing Address - Street 1:201 W CROSS ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS GROVE
Mailing Address - State:OH
Mailing Address - Zip Code:45830-1237
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:201 W CROSS ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS GROVE
Practice Address - State:OH
Practice Address - Zip Code:45830-1237
Practice Address - Country:US
Practice Address - Phone:419-659-2639
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-17
Last Update Date:2014-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH=========Medicaid