Healthcare Provider Details

I. General information

NPI: 1932299401
Provider Name (Legal Business Name): ELGIN PUBLIC SCHOOLS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

721 J ST.
ELGIN OK
73538
US

IV. Provider business mailing address

PO BOX 369
ELGIN OK
73538-0369
US

V. Phone/Fax

Practice location:
  • Phone: 580-492-3651
  • Fax:
Mailing address:
  • Phone: 580-492-3651
  • Fax:

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: BARBARA STROUD
Title or Position: MEDICAID DIRECTOR
Credential:
Phone: 580-492-3651