Provider Demographics
NPI:1497146989
Name:COLUMBUS ARTS & TECHNOLOGY ACADEMY
Entity Type:Organization
Organization Name:COLUMBUS ARTS & TECHNOLOGY ACADEMY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEAD OF SCHOOL
Authorized Official - Prefix:MR
Authorized Official - First Name:DERRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:SHELTON
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:614-577-0900
Mailing Address - Street 1:2255 KIMBERLY PKWY E
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43232-7210
Mailing Address - Country:US
Mailing Address - Phone:614-577-0900
Mailing Address - Fax:614-886-0300
Practice Address - Street 1:2255 KIMBERLY PKWY E
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43232-7210
Practice Address - Country:US
Practice Address - Phone:614-577-0900
Practice Address - Fax:614-866-0300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-05
Last Update Date:2015-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)