Provider Demographics
NPI:1528179322
Name:GALLIPOLIS CITY SCHOOLS
Entity Type:Organization
Organization Name:GALLIPOLIS CITY SCHOOLS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PREVENTION SERVICES COORDINATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:R
Authorized Official - Last Name:GODWIN
Authorized Official - Suffix:
Authorized Official - Credentials:OCPSII
Authorized Official - Phone:740-446-3212
Mailing Address - Street 1:340 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:GALLIPOLIS
Mailing Address - State:OH
Mailing Address - Zip Code:45631-1109
Mailing Address - Country:US
Mailing Address - Phone:740-446-3212
Mailing Address - Fax:740-446-3436
Practice Address - Street 1:340 4TH AVE
Practice Address - Street 2:
Practice Address - City:GALLIPOLIS
Practice Address - State:OH
Practice Address - Zip Code:45631-1109
Practice Address - Country:US
Practice Address - Phone:740-446-3212
Practice Address - Fax:740-446-3436
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH044032251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH03116Medicare UPIN