Provider Demographics
NPI:1194162214
Name:GENTRY PUBLIC SCHOOL
Entity type:Organization
Organization Name:GENTRY PUBLIC SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:BARRETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:479-736-2253
Mailing Address - Street 1:201 S GILES AVE
Mailing Address - Street 2:
Mailing Address - City:GENTRY
Mailing Address - State:AR
Mailing Address - Zip Code:72734-9320
Mailing Address - Country:US
Mailing Address - Phone:479-736-2253
Mailing Address - Fax:479-736-5682
Practice Address - Street 1:201 S GILES AVE
Practice Address - Street 2:
Practice Address - City:GENTRY
Practice Address - State:AR
Practice Address - Zip Code:72734-9320
Practice Address - Country:US
Practice Address - Phone:479-736-2253
Practice Address - Fax:479-736-5682
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-30
Last Update Date:2013-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR194386720OtherAUDIOLOGY