Healthcare Provider Details

I. General information

NPI: 1659590149
Provider Name (Legal Business Name): BOARD OF EDUCATION DISTRICT I-19 ARDMORE CITY SCHOOLS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2007
Last Update Date: 07/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 M ST NE
ARDMORE OK
73401
US

IV. Provider business mailing address

PO BOX 1709
ARDMORE OK
73402-1709
US

V. Phone/Fax

Practice location:
  • Phone: 580-226-7650
  • Fax: 580-221-3002
Mailing address:
  • Phone: 580-226-7650
  • Fax: 580-221-3002

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State

VIII. Authorized Official

Name: DR. RUTH ANN CARR
Title or Position: SUPERINTENDENT
Credential:
Phone: 580-226-7650