Basic Information
Provider Information
NPI: 1366636177
EntityType: 2
ReplacementNPI:  
OrganizationName: SUMMIT ACADEMY COMMUNITY SCHOOL COLUMBUS
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
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Credential:  
OtherOrganizationName:  
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Mailing Information
Address1: 1111 W MARKET ST
Address2:  
City: AKRON
State: OH
PostalCode: 443137122
CountryCode: US
TelephoneNumber: 3308366200
FaxNumber: 3308368614
Practice Location
Address1: 1855 E DUBLIN GRANVILLE RD
Address2:  
City: COLUMBUS
State: OH
PostalCode: 432293516
CountryCode: US
TelephoneNumber: 3308366200
FaxNumber: 3308368216
Other Information
ProviderEnumerationDate: 09/05/2007
LastUpdateDate: 09/05/2007
NPIDeactivationReasonCode:  
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ProviderGenderCode:  
AuthorizedOfficialLastName: HOLZAPFEL
AuthorizedOfficialFirstName: GERALD
AuthorizedOfficialMiddleName: P
AuthorizedOfficialTitleorPosition: CFO
AuthorizedOfficialTelephone: 3308366200
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: MR.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
251300000X  Y AgenciesLocal Education Agency (LEA) 

No ID Information.


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