Provider Demographics
NPI:1881728053
Name:GERONIMO PUBLIC SCHOOL
Entity type:Organization
Organization Name:GERONIMO PUBLIC SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:R
Authorized Official - Last Name:MCLAIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:580-355-3801
Mailing Address - Street 1:PO BOX 99
Mailing Address - Street 2:
Mailing Address - City:GERONIMO
Mailing Address - State:OK
Mailing Address - Zip Code:73543-0099
Mailing Address - Country:US
Mailing Address - Phone:580-355-3801
Mailing Address - Fax:580-357-8307
Practice Address - Street 1:225 IOWA STREET
Practice Address - Street 2:
Practice Address - City:GERONIMO
Practice Address - State:OK
Practice Address - Zip Code:73543-0099
Practice Address - Country:US
Practice Address - Phone:580-355-3801
Practice Address - Fax:580-357-8307
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)