Provider Demographics
NPI:1427188804
Name:PICKAWAY COUNTY EDUCATIONAL SERVICE CENTER
Entity Type:Organization
Organization Name:PICKAWAY COUNTY EDUCATIONAL SERVICE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:K
Authorized Official - Last Name:CLARK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-474-7529
Mailing Address - Street 1:2050 STONERIDGE DR
Mailing Address - Street 2:
Mailing Address - City:CIRCLEVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43113-8954
Mailing Address - Country:US
Mailing Address - Phone:740-474-7529
Mailing Address - Fax:740-474-7251
Practice Address - Street 1:2050 STONERIDGE DR
Practice Address - Street 2:
Practice Address - City:CIRCLEVILLE
Practice Address - State:OH
Practice Address - Zip Code:43113-8954
Practice Address - Country:US
Practice Address - Phone:740-474-7529
Practice Address - Fax:740-474-7251
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)