Provider Demographics
NPI:1225181449
Name:SUPERINTENDENT OF SCHOOLS HARRISON SCHOOL DISTRICT
Entity Type:Organization
Organization Name:SUPERINTENDENT OF SCHOOLS HARRISON SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MELINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:MOSS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-741-7600
Mailing Address - Street 1:110 S CHERRY ST
Mailing Address - Street 2:
Mailing Address - City:HARRISON
Mailing Address - State:AR
Mailing Address - Zip Code:72601-5024
Mailing Address - Country:US
Mailing Address - Phone:870-741-7600
Mailing Address - Fax:870-741-4520
Practice Address - Street 1:110 S CHERRY ST
Practice Address - Street 2:
Practice Address - City:HARRISON
Practice Address - State:AR
Practice Address - Zip Code:72601-5024
Practice Address - Country:US
Practice Address - Phone:870-741-7600
Practice Address - Fax:870-741-4520
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-19
Last Update Date:2015-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR116054743Medicaid
AR123005761Medicaid
AR159528791Medicaid
AR158938732Medicaid