Provider Demographics
NPI:1861569519
Name:JUNCTION CITY SCHOOL
Entity type:Organization
Organization Name:JUNCTION CITY SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:
Authorized Official - Last Name:WAYMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-924-4575
Mailing Address - Street 1:PO BOX 790
Mailing Address - Street 2:100 WEST HOLLY
Mailing Address - City:JUNCTION CITY
Mailing Address - State:AR
Mailing Address - Zip Code:71749-0790
Mailing Address - Country:US
Mailing Address - Phone:870-924-4575
Mailing Address - Fax:870-924-4565
Practice Address - Street 1:100 WEST HOLLY
Practice Address - Street 2:
Practice Address - City:JUNCTION CITY
Practice Address - State:AR
Practice Address - Zip Code:71749-0790
Practice Address - Country:US
Practice Address - Phone:870-924-4575
Practice Address - Fax:870-924-4565
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2008-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
163W00000X
AR25130000X-LEA251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251300000XAgenciesLocal Education Agency (LEA)
No163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR0130190473Medicaid