Provider Demographics
NPI:1811023765
Name:PARKERS CHAPEL SCHOOL
Entity Type:Organization
Organization Name:PARKERS CHAPEL SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:GROSS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-862-4641
Mailing Address - Street 1:401 PARKERS CHAPEL RD
Mailing Address - Street 2:
Mailing Address - City:EL DORADO
Mailing Address - State:AR
Mailing Address - Zip Code:71730-7981
Mailing Address - Country:US
Mailing Address - Phone:870-862-4641
Mailing Address - Fax:870-881-5092
Practice Address - Street 1:401 PARKERS CHAPEL RD
Practice Address - Street 2:
Practice Address - City:EL DORADO
Practice Address - State:AR
Practice Address - Zip Code:71730-7981
Practice Address - Country:US
Practice Address - Phone:870-924-4598
Practice Address - Fax:870-881-5092
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
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR116844743Medicaid
AR165350761Medicaid