Provider Demographics
NPI:1831281005
Name:WISTER PUBLIC SCHOOL
Entity Type:Organization
Organization Name:WISTER PUBLIC SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:F
Authorized Official - Last Name:CARPENTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-655-3132
Mailing Address - Street 1:201 LOGAN ST
Mailing Address - Street 2:
Mailing Address - City:WISTER
Mailing Address - State:OK
Mailing Address - Zip Code:74966-9627
Mailing Address - Country:US
Mailing Address - Phone:918-655-3132
Mailing Address - Fax:918-655-7402
Practice Address - Street 1:201 LOGAN ST
Practice Address - Street 2:
Practice Address - City:WISTER
Practice Address - State:OK
Practice Address - Zip Code:74966-9627
Practice Address - Country:US
Practice Address - Phone:918-655-3132
Practice Address - Fax:918-655-7402
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare