# BRUSHY ELEMENTARY SCHOOL

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1861773012
- **Authorized official:** MRS. SHANNON RENE EDWARDS RN, BSN (SCHOOL NURSE/MEDICAID COORDINATOR)
- **Authorized official phone:** (918) 775-4458

## Contact information

- **Practice address:** 100968 S 4650 RD, SALLISAW, OK 74955-2672
- **Practice address phone:** (918) 775-4458
- **Practice address fax:** (918) 775-3638
- **Mailing address:** 100968 S 4650 RD, SALLISAW, OK 74955-2672
- **Mailing address phone:** (918) 775-4458
- **Mailing address fax:** (918) 775-3638

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251K00000X | Public Health or Welfare Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 09/01/2011
- **Last updated:** 09/01/2011