Provider Demographics
NPI:1205378429
Name:STARKVILLE OKTIBBEHA CONSOLIDATED SCHOOL DISTRICT
Entity Type:Organization
Organization Name:STARKVILLE OKTIBBEHA CONSOLIDATED SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LEWIS
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLLOWAY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:662-324-4050
Mailing Address - Street 1:307 S JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:STARKVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:39759-3347
Mailing Address - Country:US
Mailing Address - Phone:662-324-4193
Mailing Address - Fax:662-324-6914
Practice Address - Street 1:307 S JACKSON ST
Practice Address - Street 2:
Practice Address - City:STARKVILLE
Practice Address - State:MS
Practice Address - Zip Code:39759-3347
Practice Address - Country:US
Practice Address - Phone:662-324-4193
Practice Address - Fax:662-324-6914
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-07
Last Update Date:2016-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR870489163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty