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General NPI Number Information
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NPI Number | 1306033279
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Entity Type | Organization
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Legal Business Name | SUPT OF OZARK SCHOOL DISTRICT NO 14
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Dates
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Enumeration Date | 09/25/2007
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Last Update Date | 06/19/2008
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Provider Practice Location Address
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Address Line | 525 HENDRIX ST
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City | ALTUS
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State | AR
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Zip | 72821
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Country | US
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Telephone | 479-468-3440
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Fax | 479-468-2135
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Provider Business Mailing Address
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Address Line | 1609 WALDRON ROAD
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City | OZARK
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State | AR
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Zip | 72949
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Country | US
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Telephone | 479-468-3440
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Fax | 479-468-2135
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Authorized Official
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Title or Position | SCHOOL NURSE
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Name | MRS. SHERRY POTTORFF
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Credential | LPN
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Telephone | 479-468-3440
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251300000X
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Taxonomy Name | Local Education Agency (LEA)
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License Number |
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License Number State | AR
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