Provider Demographics
NPI:1144371956
Name:POYEN SCHOOL DISTRICT NO 1
Entity type:Organization
Organization Name:POYEN SCHOOL DISTRICT NO 1
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RONNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:KISSIRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-332-8884
Mailing Address - Street 1:11636 HIGHWAY 84
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:AR
Mailing Address - Zip Code:71929-7473
Mailing Address - Country:US
Mailing Address - Phone:501-865-4506
Mailing Address - Fax:501-865-4545
Practice Address - Street 1:14296 HWY 270 W
Practice Address - Street 2:
Practice Address - City:POYEN
Practice Address - State:AR
Practice Address - Zip Code:72128-0209
Practice Address - Country:US
Practice Address - Phone:501-332-8884
Practice Address - Fax:501-332-8886
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
Last Update Date:2019-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2703251300000X
251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR123457742Medicaid
AR194204732Medicaid
AR116463743Medicaid
AR166622761Medicaid