Provider Demographics
NPI:1104986009
Name:MSD OF NORTH POSEY COUNTY
Entity type:Organization
Organization Name:MSD OF NORTH POSEY COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:D
Authorized Official - Last Name:WOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-874-2234
Mailing Address - Street 1:101 N CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:POSEYVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47633-9026
Mailing Address - Country:US
Mailing Address - Phone:812-874-2243
Mailing Address - Fax:812-874-8806
Practice Address - Street 1:101 N CHURCH ST
Practice Address - Street 2:
Practice Address - City:POSEYVILLE
Practice Address - State:IN
Practice Address - Zip Code:47633-9026
Practice Address - Country:US
Practice Address - Phone:812-874-2243
Practice Address - Fax:812-874-8806
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-11
Last Update Date:2007-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN656600Medicare ID - Type UnspecifiedPUBLIC SCHOOL CORPORATION