Provider Demographics
NPI:1578928354
Name:TUPELO PUBLIC SCHOOL
Entity Type:Organization
Organization Name:TUPELO PUBLIC SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:ROMINES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:580-845-2460
Mailing Address - Street 1:200 S 7TH AVE
Mailing Address - Street 2:
Mailing Address - City:TUPELO
Mailing Address - State:OK
Mailing Address - Zip Code:74572-7201
Mailing Address - Country:US
Mailing Address - Phone:580-845-2460
Mailing Address - Fax:580-845-2565
Practice Address - Street 1:200 S 7TH AVE
Practice Address - Street 2:
Practice Address - City:TUPELO
Practice Address - State:OK
Practice Address - Zip Code:74572-7201
Practice Address - Country:US
Practice Address - Phone:580-845-2460
Practice Address - Fax:580-845-2565
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-22
Last Update Date:2015-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty