MEDICARE: BELFONTE ELEMENTARY 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	:	1881777480
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BELFONTE ELEMENTARY SCHOOL

Provider Business Mailing Address
First Line	:	475751 STATE HIGHWAY 101
Second Line	:
City	:	MULDROW
State	:	OK
Zip	:	74948-6520
Country	:	US
Telephone Number	:	918-427-3522
Fax Number	:	918-427-1288

Provider Business Practice Location Address
First Line	:	475751 STATE HIGHWAY 101
Second Line	:
City	:	MULDROW
State	:	OK
Zip	:	74948-6520
Country	:	US
Telephone Number	:	918-427-3522
Fax Number	:	918-427-1288

Authorized Official
Title or Position	:	SUPERINTENDENT
Name	:	MR. LUCKY L MCCRARY
Credential	:
Telephone Number	:	918-427-3522

Provider Enumeration Date	:	10/24/2006
Last Update Date	:	08/22/2020

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Directions to “BELFONTE ELEMENTARY SCHOOL ” Practice Location

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