Provider Demographics
NPI:1639393911
Name:BOARD OF EDUCATION WAPANUCKA SCHOOL DISTRICT I037
Entity type:Organization
Organization Name:BOARD OF EDUCATION WAPANUCKA SCHOOL DISTRICT I037
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:STANLEY
Authorized Official - Middle Name:P
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:580-937-4288
Mailing Address - Street 1:PO BOX 188
Mailing Address - Street 2:502 SOUTH CHOCTAW AVENUE
Mailing Address - City:WAPANUCKA
Mailing Address - State:OK
Mailing Address - Zip Code:73461-0188
Mailing Address - Country:US
Mailing Address - Phone:580-937-4288
Mailing Address - Fax:580-937-4801
Practice Address - Street 1:502 S. CHOCTAW AVE.
Practice Address - Street 2:
Practice Address - City:WAPANUCKA
Practice Address - State:OK
Practice Address - Zip Code:73461-0188
Practice Address - Country:US
Practice Address - Phone:580-937-4288
Practice Address - Fax:580-937-4801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-11
Last Update Date:2008-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100687480AMedicaid