Healthcare Provider Details

I. General information

NPI: 1740513225
Provider Name (Legal Business Name): COUCH SCHOOL DISTRICT R-I
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2009
Last Update Date: 09/15/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

RR 1 BOX 1187
MYRTLE MO
65778-9740
US

IV. Provider business mailing address

RR 1 BOX 1187
MYRTLE MO
65778-9740
US

V. Phone/Fax

Practice location:
  • Phone: 417-938-4211
  • Fax: 417-938-4267
Mailing address:
  • Phone: 417-938-4211
  • Fax: 417-938-4267

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MR. TOM BULL
Title or Position: SUPERINTENDENT
Credential: SUPERINTENDENT
Phone: 417-938-4211