Provider Demographics
NPI:1164404190
Name:WESTVILLE PUBLIC SCHOOL
Entity Type:Organization
Organization Name:WESTVILLE PUBLIC SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHERRI
Authorized Official - Middle Name:
Authorized Official - Last Name:PRENTICE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-723-3181
Mailing Address - Street 1:500 W. CHINCAPIN
Mailing Address - Street 2:
Mailing Address - City:WESTVILLE
Mailing Address - State:OK
Mailing Address - Zip Code:74965-0410
Mailing Address - Country:US
Mailing Address - Phone:918-723-3181
Mailing Address - Fax:918-723-3042
Practice Address - Street 1:500 W. CHINCAPIN
Practice Address - Street 2:
Practice Address - City:WESTVILLE
Practice Address - State:OK
Practice Address - Zip Code:74965-0410
Practice Address - Country:US
Practice Address - Phone:918-723-3181
Practice Address - Fax:918-723-3042
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-16
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100681960AMedicaid