Provider Demographics
NPI:1063580165
Name:EAST END SCHOOL
Entity type:Organization
Organization Name:EAST END SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:TYLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-759-2808
Mailing Address - Street 1:114 WEST PANTHER DRIVE
Mailing Address - Street 2:
Mailing Address - City:BIGELOW
Mailing Address - State:AR
Mailing Address - Zip Code:72016-0360
Mailing Address - Country:US
Mailing Address - Phone:501-759-2808
Mailing Address - Fax:501-759-2667
Practice Address - Street 1:114 W PANTHER DR
Practice Address - Street 2:
Practice Address - City:BIGELOW
Practice Address - State:AR
Practice Address - Zip Code:72016
Practice Address - Country:US
Practice Address - Phone:501-759-2808
Practice Address - Fax:501-759-2667
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-30
Last Update Date:2008-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR148012742Medicaid