Healthcare Provider Details

I. General information

NPI: 1528151537
Provider Name (Legal Business Name): EL RENO PUBLIC SCHOOLS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 S KEITH AVE
EL RENO OK
73036-4308
US

IV. Provider business mailing address

PO BOX 580
EL RENO OK
73036-0580
US

V. Phone/Fax

Practice location:
  • Phone: 405-262-1941
  • Fax:
Mailing address:
  • Phone: 405-262-2601
  • Fax: 405-262-3280

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MRS. PAMELA G MILLER
Title or Position: SPECIAL EDUCATION DIRECTOR
Credential:
Phone: 405-262-2601