Healthcare Provider Details

I. General information

NPI: 1609847573
Provider Name (Legal Business Name): COTTONWOOD PUBLIC SCHOOL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

LUBBIS ST 2 MI NE OF COALGATE OK ON STATE HWY 31
COTTONWOOD OK
74538-0347
US

IV. Provider business mailing address

PO BOX 347
COALGATE OK
74538-0347
US

V. Phone/Fax

Practice location:
  • Phone: 580-927-2937
  • Fax: 580-927-2938
Mailing address:
  • Phone: 580-927-2937
  • Fax: 580-927-2938

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. TERI BRECHEEN
Title or Position: SCHOOL SUPERINTENDENT
Credential:
Phone: 580-927-2937