Provider Demographics
NPI:1265623227
Name:MAD RIVER LOCAL SCHOOLS
Entity type:Organization
Organization Name:MAD RIVER LOCAL SCHOOLS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:EAGLOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-259-6606
Mailing Address - Street 1:801 OLD HARSHMAN RD
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45431-1238
Mailing Address - Country:US
Mailing Address - Phone:937-259-6607
Mailing Address - Fax:
Practice Address - Street 1:801 OLD HARSHMAN RD
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45431-1238
Practice Address - Country:US
Practice Address - Phone:937-259-6607
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-06
Last Update Date:2007-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)