Healthcare Provider Details

I. General information

NPI: 1164576781
Provider Name (Legal Business Name): SUPERINTENDENT OF FARMINGTON SCHOOL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2007
Last Update Date: 07/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

363 MCKNIGHT
WEST FORK AR
72774-0419
US

IV. Provider business mailing address

363 MCKNIGHT
WEST FORK AR
72774-0419
US

V. Phone/Fax

Practice location:
  • Phone: 479-839-3035
  • Fax: 479-839-3037
Mailing address:
  • Phone: 479-839-3035
  • Fax: 479-839-3037

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number State

VIII. Authorized Official

Name: MS. FELICIA PASLEY
Title or Position: LEA DIRECTOR
Credential:
Phone: 479-839-3035