Healthcare Provider Details

I. General information

NPI: 1346231826
Provider Name (Legal Business Name): SAYRE PUBLIC SCHOOLS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

716 NE 66TH ST
SAYRE OK
73662
US

IV. Provider business mailing address

716 NE 66TH ST
SAYRE OK
73662
US

V. Phone/Fax

Practice location:
  • Phone: 580-928-2013
  • Fax: 580-928-3936
Mailing address:
  • Phone: 580-928-2013
  • Fax: 580-928-3936

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MS. LORI S PARKER
Title or Position: MEDICAID COORDINATOR
Credential:
Phone: 580-928-2013