Provider Demographics
NPI:1013049865
Name:MIDWAY PUBLIC SCHOOL
Entity Type:Organization
Organization Name:MIDWAY PUBLIC SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING CLERK
Authorized Official - Prefix:MRS
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:VOIGT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-474-3434
Mailing Address - Street 1:3RD & PINE STREET
Mailing Address - Street 2:P. O. BOX 170
Mailing Address - City:COUNCIL HILL
Mailing Address - State:OK
Mailing Address - Zip Code:74428
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3RD & PINE ST.
Practice Address - Street 2:BOX 170
Practice Address - City:COUNCIL HILL
Practice Address - State:OK
Practice Address - Zip Code:74428
Practice Address - Country:US
Practice Address - Phone:918-474-3434
Practice Address - Fax:918-474-3636
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2007-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)