Provider Demographics
NPI:1679797716
Name:WARNER PUBLIC SCHOOLS
Entity Type:Organization
Organization Name:WARNER PUBLIC SCHOOLS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAID CORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:VICKEY
Authorized Official - Middle Name:L
Authorized Official - Last Name:WARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-463-5171
Mailing Address - Street 1:1012 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:WARNER
Mailing Address - State:OK
Mailing Address - Zip Code:74469-6900
Mailing Address - Country:US
Mailing Address - Phone:918-463-5171
Mailing Address - Fax:918-463-2542
Practice Address - Street 1:1012 5TH AVE
Practice Address - Street 2:
Practice Address - City:WARNER
Practice Address - State:OK
Practice Address - Zip Code:74469-6900
Practice Address - Country:US
Practice Address - Phone:918-463-5171
Practice Address - Fax:918-463-2542
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-12
Last Update Date:2015-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100681580 AOtherOHCA