Provider Demographics
NPI:1154519387
Name:ALPENA SCHOOL
Entity type:Organization
Organization Name:ALPENA SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SCHOOL NURSE
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:A
Authorized Official - Last Name:SCROGGIE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:870-437-2229
Mailing Address - Street 1:300 S. DENVER ST
Mailing Address - Street 2:
Mailing Address - City:ALPENA
Mailing Address - State:AR
Mailing Address - Zip Code:72611
Mailing Address - Country:US
Mailing Address - Phone:870-437-2220
Mailing Address - Fax:
Practice Address - Street 1:300 S DENVER ST
Practice Address - Street 2:
Practice Address - City:ALPENA
Practice Address - State:AR
Practice Address - Zip Code:72611-2939
Practice Address - Country:US
Practice Address - Phone:870-437-2220
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-12
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
AR=========Medicaid