Provider Demographics
NPI:1518093459
Name:SMACKOVER SCHOOL DISTRICT
Entity Type:Organization
Organization Name:SMACKOVER SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DARYL
Authorized Official - Middle Name:
Authorized Official - Last Name:PORTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-725-3132
Mailing Address - Street 1:1406 LISBON RD
Mailing Address - Street 2:
Mailing Address - City:SMACKOVER
Mailing Address - State:AR
Mailing Address - Zip Code:71762-9703
Mailing Address - Country:US
Mailing Address - Phone:870-725-3132
Mailing Address - Fax:870-725-2385
Practice Address - Street 1:1406 LISBON RD
Practice Address - Street 2:
Practice Address - City:SMACKOVER
Practice Address - State:AR
Practice Address - Zip Code:71762-9703
Practice Address - Country:US
Practice Address - Phone:870-725-3132
Practice Address - Fax:870-725-2385
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-26
Last Update Date:2008-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
163W00000X
AR251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251300000XAgenciesLocal Education Agency (LEA)
No163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty