Provider Demographics
NPI:1093950891
Name:OHIO STATE SCHOOL FOR THE BLIND
Entity type:Organization
Organization Name:OHIO STATE SCHOOL FOR THE BLIND
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACTING SUPERINTENDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:MA, NCSP
Authorized Official - Phone:614-752-1660
Mailing Address - Street 1:5220 N HIGH ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43214-1240
Mailing Address - Country:US
Mailing Address - Phone:614-752-1152
Mailing Address - Fax:614-752-1713
Practice Address - Street 1:5220 N HIGH ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-1240
Practice Address - Country:US
Practice Address - Phone:614-752-1152
Practice Address - Fax:614-752-1713
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-08
Last Update Date:2008-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2509842Medicaid