1558584581 NPI number — MOUNTAIN VIEW-GOTEBO PUBLIC SCHOOL

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1558584581 NPI number — MOUNTAIN VIEW-GOTEBO PUBLIC SCHOOL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MOUNTAIN VIEW-GOTEBO PUBLIC SCHOOL
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1558584581
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
124 SOUTH FIRST
Provider Second Line Business Mailing Address:
RT. 2, BOX 88
Provider Business Mailing Address City Name:
MOUNTAIN VIEW
Provider Business Mailing Address State Name:
OK
Provider Business Mailing Address Postal Code:
73062-9622
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
580-347-2211
Provider Business Mailing Address Fax Number:
580-347-2869

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
124 SOUTH FIRST
Provider Second Line Business Practice Location Address:
RT. 2, BOX 88
Provider Business Practice Location Address City Name:
MOUNTAIN VIEW
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
73062-9622
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
580-347-2211
Provider Business Practice Location Address Fax Number:
580-347-2869
Provider Enumeration Date:
04/10/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
SQUIRES
Authorized Official First Name:
PAULA
Authorized Official Middle Name:
D.
Authorized Official Title or Position:
SUPERINTENDENT
Authorized Official Telephone Number:
580-347-2211

Provider Taxonomy Codes

  • Taxonomy code: 251300000X , registered in the state of OK ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)