MEDICARE: COALGATE PUBLIC 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	251300000X	Local Education Agency (LEA)

General Provider Information

NPI Number	:	1578603577
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COALGATE PUBLIC SCHOOL

Provider Business Mailing Address
First Line	:	PO BOX 368
Second Line	:	3 WEST CEDAR
City	:	COALGATE
State	:	OK
Zip	:	74538-0368
Country	:	US
Telephone Number	:	580-927-2338
Fax Number	:	580-927-3537

Provider Business Practice Location Address
First Line	:	3 WEST CEDAR
Second Line	:
City	:	COALGATE
State	:	OK
Zip	:	74538-0368
Country	:	US
Telephone Number	:	580-927-2338
Fax Number	:	580-927-3537

Authorized Official
Title or Position	:	SUPERINTENDENT
Name	:	MR. JIM GIRTEN
Credential	:
Telephone Number	:	580-927-2338

Provider Enumeration Date	:	02/07/2007
Last Update Date	:	08/22/2020

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Directions to “COALGATE PUBLIC SCHOOL ” Practice Location

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