MEDICARE: ALLEN BOWDEN SCHOOL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251K00000X	Public Health or Welfare Agency		OK

General Provider Information

NPI Number	:	1285798942
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALLEN BOWDEN SCHOOL

Provider Business Mailing Address
First Line	:	7049 FRANKOMA RD
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74131-2018
Country	:	US
Telephone Number	:	918-224-4440
Fax Number	:	918-224-0617

Provider Business Practice Location Address
First Line	:	7049 FRANKOMA RD
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74131-2018
Country	:	US
Telephone Number	:	918-224-4440
Fax Number	:	918-224-0617

Authorized Official
Title or Position	:	SCHOOL NURSE
Name	:	LUCILE MCDONALD HENDRICKS
Credential	:	REGISTERED NURSE
Telephone Number	:	918-224-4952

Provider Enumeration Date	:	12/20/2006
Last Update Date	:	08/22/2020

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