MEDICARE: SAYRE PUBLIC SCHOOLS

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	:	1346231826
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAYRE PUBLIC SCHOOLS

Provider Business Mailing Address
First Line	:	716 NE 66TH ST
Second Line	:
City	:	SAYRE
State	:	OK
Zip	:	73662
Country	:	US
Telephone Number	:	580-928-2013
Fax Number	:	580-928-3936

Provider Business Practice Location Address
First Line	:	716 NE 66TH ST
Second Line	:
City	:	SAYRE
State	:	OK
Zip	:	73662
Country	:	US
Telephone Number	:	580-928-2013
Fax Number	:	580-928-3936

Authorized Official
Title or Position	:	MEDICAID COORDINATOR
Name	:	MS. LORI S PARKER
Credential	:
Telephone Number	:	580-928-2013

Provider Enumeration Date	:	11/02/2005
Last Update Date	:	08/22/2020

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Directions to “SAYRE PUBLIC SCHOOLS ” Practice Location

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