Provider Demographics
NPI:1164576781
Name:SUPERINTENDENT OF FARMINGTON SCHOOL
Entity Type:Organization
Organization Name:SUPERINTENDENT OF FARMINGTON SCHOOL
Other - Org Name:FARMINGTON PUBLIC SCHOOL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:LEA DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:FELICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:PASLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:479-839-3035
Mailing Address - Street 1:363 MCKNIGHT
Mailing Address - Street 2:
Mailing Address - City:WEST FORK
Mailing Address - State:AR
Mailing Address - Zip Code:72774-0419
Mailing Address - Country:US
Mailing Address - Phone:479-839-3035
Mailing Address - Fax:479-839-3037
Practice Address - Street 1:363 MCKNIGHT
Practice Address - Street 2:
Practice Address - City:WEST FORK
Practice Address - State:AR
Practice Address - Zip Code:72774-0419
Practice Address - Country:US
Practice Address - Phone:479-839-3035
Practice Address - Fax:479-839-3037
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-22
Last Update Date:2008-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR122245743Medicaid
AR122396742Medicaid