MEDICARE: ELK CITY PUBIC 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	251300000X	Local Education Agency (LEA)

General Provider Information

NPI Number	:	1710082326
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELK CITY PUBIC SCHOOLS

Provider Business Mailing Address
First Line	:	222 W BROADWAY AVE
Second Line	:
City	:	ELK CITY
State	:	OK
Zip	:	73644-4742
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	222 W BROADWAY AVE
Second Line	:
City	:	ELK CITY
State	:	OK
Zip	:	73644-4742
Country	:	US
Telephone Number	:	580-225-0175
Fax Number	:	580-225-8644

Authorized Official
Title or Position	:	DIRECTOR
Name	:	CINDY L. BUCKMASTER
Credential	:
Telephone Number	:	580-225-0175

Provider Enumeration Date	:	09/14/2006
Last Update Date	:	08/22/2020

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Directions to “ELK CITY PUBIC SCHOOLS ” Practice Location

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