Provider Demographics
NPI:1407093503
Name:FOSTORIA CITY SCHOOLS
Entity Type:Organization
Organization Name:FOSTORIA CITY SCHOOLS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:RUSSOMANNO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-436-4162
Mailing Address - Street 1:1001 PARK AVENUE
Mailing Address - Street 2:
Mailing Address - City:FOSTORIA
Mailing Address - State:OH
Mailing Address - Zip Code:44830
Mailing Address - Country:US
Mailing Address - Phone:419-435-8163
Mailing Address - Fax:419-436-4153
Practice Address - Street 1:1001 PARK AVENUE
Practice Address - Street 2:
Practice Address - City:FOSTORIA
Practice Address - State:OH
Practice Address - Zip Code:44830
Practice Address - Country:US
Practice Address - Phone:409-436-4162
Practice Address - Fax:419-436-4153
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-12
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH7400173Medicaid