Healthcare Provider Details

I. General information

NPI: 1720381775
Provider Name (Legal Business Name): OKARCHE PUBLIC SCHOOL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/14/2010
Last Update Date: 12/14/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 NORTH 4TH STREET
OKARCHE OK
73762-0276
US

IV. Provider business mailing address

P.O. BOX 276 205 NORTH 4TH STREET
OKARCHE OK
73762-0276
US

V. Phone/Fax

Practice location:
  • Phone: 405-263-7300
  • Fax: 405-263-7515
Mailing address:
  • Phone: 405-263-7300
  • Fax: 405-263-7515

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: BRANDI NICOLE KRITTENBRINK
Title or Position: EDUCATOR
Credential:
Phone: 405-263-7212