Provider Demographics
NPI:1558507079
Name:RUSSIA LOCAL SCHOOL
Entity Type:Organization
Organization Name:RUSSIA LOCAL SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:E
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-526-3156
Mailing Address - Street 1:100 SCHOOL ST
Mailing Address - Street 2:
Mailing Address - City:RUSSIA
Mailing Address - State:OH
Mailing Address - Zip Code:45363-9811
Mailing Address - Country:US
Mailing Address - Phone:937-526-3156
Mailing Address - Fax:937-526-9519
Practice Address - Street 1:100 SCHOOL ST
Practice Address - Street 2:
Practice Address - City:RUSSIA
Practice Address - State:OH
Practice Address - Zip Code:45363-9811
Practice Address - Country:US
Practice Address - Phone:937-526-3156
Practice Address - Fax:937-526-9519
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-06
Last Update Date:2009-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH049817251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)