MEDICARE: COLCORD 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	251300000X	Local Education Agency (LEA)	100688010A	OK

General Provider Information

NPI Number	:	1780739011
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COLCORD PUBLIC SCHOOLS

Provider Business Mailing Address
First Line	:	PO BOX 188
Second Line	:
City	:	COLCORD
State	:	OK
Zip	:	74338
Country	:	US
Telephone Number	:	918-326-4116
Fax Number	:	918-326-4471

Provider Business Practice Location Address
First Line	:	433 SOUTH LARMON ST
Second Line	:
City	:	COLCORD
State	:	OK
Zip	:	74338
Country	:	US
Telephone Number	:	918-326-4116
Fax Number	:	918-326-4471

Authorized Official
Title or Position	:	SUPERINTENDENT OF SCHOOLS
Name	:	KELLY J HAMPTON
Credential	:
Telephone Number	:	918-326-4116

Provider Enumeration Date	:	01/25/2007
Last Update Date	:	07/16/2008

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Directions to “COLCORD PUBLIC SCHOOLS ” Practice Location

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