Provider Demographics
NPI:1164580247
Name:DARDANELLE SCHOOL
Entity Type:Organization
Organization Name:DARDANELLE SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:479-229-4111
Mailing Address - Street 1:209 CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:DARDANELLE
Mailing Address - State:AR
Mailing Address - Zip Code:72834-3215
Mailing Address - Country:US
Mailing Address - Phone:479-229-4111
Mailing Address - Fax:479-229-1387
Practice Address - Street 1:209 CEDAR ST
Practice Address - Street 2:
Practice Address - City:DARDANELLE
Practice Address - State:AR
Practice Address - Zip Code:72834-3215
Practice Address - Country:US
Practice Address - Phone:479-229-4111
Practice Address - Fax:479-229-1387
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-04
Last Update Date:2008-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR133224743Medicaid