Provider Demographics
NPI:1710196993
Name:OWENS COMMUNITY COLLEGE
Entity Type:Organization
Organization Name:OWENS COMMUNITY COLLEGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:TRONOLONE
Authorized Official - Suffix:
Authorized Official - Credentials:RDH
Authorized Official - Phone:567-661-7374
Mailing Address - Street 1:P.O. BOX 10,000
Mailing Address - Street 2:DENTAL HYGIENE PROGRAM
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43699
Mailing Address - Country:US
Mailing Address - Phone:567-661-7290
Mailing Address - Fax:567-661-7304
Practice Address - Street 1:30335 OREGON RD
Practice Address - Street 2:
Practice Address - City:PERRYSBURG
Practice Address - State:OH
Practice Address - Zip Code:43551-4539
Practice Address - Country:US
Practice Address - Phone:567-661-7290
Practice Address - Fax:567-661-7304
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0236015Medicaid