Provider Demographics
NPI:1306064084
Name:SUPERINTENDENT OF VIOLA CONSOLIDATED SCHOOL
Entity type:Organization
Organization Name:SUPERINTENDENT OF VIOLA CONSOLIDATED SCHOOL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:MAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-458-2323
Mailing Address - Street 1:PO BOX 380
Mailing Address - Street 2:
Mailing Address - City:VIOLA
Mailing Address - State:AR
Mailing Address - Zip Code:72583-0380
Mailing Address - Country:US
Mailing Address - Phone:870-458-2511
Mailing Address - Fax:870-458-2214
Practice Address - Street 1:314 LONGHORN DR
Practice Address - Street 2:
Practice Address - City:VIOLA
Practice Address - State:AR
Practice Address - Zip Code:72583-0380
Practice Address - Country:US
Practice Address - Phone:870-612-1716
Practice Address - Fax:870-458-2214
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-20
Last Update Date:2008-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
235Z00000X
AR251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251300000XAgenciesLocal Education Agency (LEA)
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR125139743Medicaid
AR121769742Medicaid