Provider Demographics
NPI:1669580502
Name:BROKEN ARROW PUBLIC SCHOOLS
Entity type:Organization
Organization Name:BROKEN ARROW PUBLIC SCHOOLS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAID COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:GILROY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-259-4540
Mailing Address - Street 1:112 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74012-3937
Mailing Address - Country:US
Mailing Address - Phone:918-259-4540
Mailing Address - Fax:918-258-0958
Practice Address - Street 1:112 N MAIN ST
Practice Address - Street 2:
Practice Address - City:BROKEN ARROW
Practice Address - State:OK
Practice Address - Zip Code:74012-3937
Practice Address - Country:US
Practice Address - Phone:918-259-4540
Practice Address - Fax:918-258-0958
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
Not Answered224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Multi-Specialty
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Not Answered235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty