Provider Demographics
NPI:1427272616
Name:COUNTY OF GRADY MINCO SCHOOL
Entity type:Organization
Organization Name:COUNTY OF GRADY MINCO SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWNEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-352-4377
Mailing Address - Street 1:311 S.W. 6TH
Mailing Address - Street 2:BOX 428, MINCO, OK 73059
Mailing Address - City:MINCO
Mailing Address - State:OK
Mailing Address - Zip Code:73059-0428
Mailing Address - Country:US
Mailing Address - Phone:405-352-4377
Mailing Address - Fax:405-352-4006
Practice Address - Street 1:311 S.W. 6TH
Practice Address - Street 2:MINCO, OK 73059
Practice Address - City:MINCO
Practice Address - State:OK
Practice Address - Zip Code:73059-0428
Practice Address - Country:US
Practice Address - Phone:405-352-4377
Practice Address - Fax:405-352-4006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100687920AMedicaid