Healthcare Provider Details

I. General information

NPI: 1679797716
Provider Name (Legal Business Name): WARNER PUBLIC SCHOOLS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2007
Last Update Date: 11/04/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1012 5TH AVE
WARNER OK
74469-6900
US

IV. Provider business mailing address

1012 5TH AVE
WARNER OK
74469-6900
US

V. Phone/Fax

Practice location:
  • Phone: 918-463-5171
  • Fax: 918-463-2542
Mailing address:
  • Phone: 918-463-5171
  • Fax: 918-463-2542

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: VICKEY L WARD
Title or Position: MEDICAID CORDINATOR
Credential:
Phone: 918-463-5171