Provider Demographics
NPI:1871782920
Name:MCCURTAIN COUNTY EDUCATIONAL COOPERATIVE
Entity type:Organization
Organization Name:MCCURTAIN COUNTY EDUCATIONAL COOPERATIVE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:INSURANCE SPECIALIST
Authorized Official - Prefix:MS
Authorized Official - First Name:LORI
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITTEN
Authorized Official - Suffix:
Authorized Official - Credentials:NCICS
Authorized Official - Phone:580-286-3344
Mailing Address - Street 1:103 NE AVE A
Mailing Address - Street 2:
Mailing Address - City:IDABEL
Mailing Address - State:OK
Mailing Address - Zip Code:74745-3830
Mailing Address - Country:US
Mailing Address - Phone:580-286-3344
Mailing Address - Fax:580-286-5598
Practice Address - Street 1:103 NE AVE A
Practice Address - Street 2:
Practice Address - City:IDABEL
Practice Address - State:OK
Practice Address - Zip Code:74745-3830
Practice Address - Country:US
Practice Address - Phone:580-286-3344
Practice Address - Fax:580-286-5598
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-15
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK=========Medicaid