| Organization Name: | BRUSHY ELEMENTARY SCHOOL |
| NPI Number: | 1861773012 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SHANNON RENE EDWARDS (SCHOOL NURSE/MEDICAID COORDINATOR) |
| Mailing Address: | 100968 S 4650 Rd Sallisaw |
| State: | OK US |
| Postal Code: | 749552672 |
| Phone Number: | 9187754458 |
| Fax Number: | 9187753638 |
| NPI Enumeration Date: | 09/01/2011 |
| NPI Last Update Date: | 09/01/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 251K00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | Public Health or Welfare |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |