Healthcare Provider Details

I. General information

NPI: 1861574337
Provider Name (Legal Business Name): ROCK CREEK PUBLIC SCHOOL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/20/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 E STEAKLEY STREET
BOKCHITO OK
74726-1115
US

IV. Provider business mailing address

200 E STEAKLEY ST
BOKCHITO OK
74726-1115
US

V. Phone/Fax

Practice location:
  • Phone: 580-295-3137
  • Fax: 580-295-3762
Mailing address:
  • Phone: 580-295-3137
  • Fax: 580-295-3762

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: MR. PRESTON BURNS
Title or Position: SUPERINTENDENT
Credential:
Phone: 580-295-3137