Provider Demographics
NPI:1114076445
Name:LORING HOSPITAL
Entity Type:Organization
Organization Name:LORING HOSPITAL
Other - Org Name:LORING HOSPITAL HOME HEALTH AGENCY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MS
Authorized Official - First Name:STACY
Authorized Official - Middle Name:J
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:712-662-6383
Mailing Address - Street 1:211 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:SAC CITY
Mailing Address - State:IA
Mailing Address - Zip Code:50583-2416
Mailing Address - Country:US
Mailing Address - Phone:712-662-7105
Mailing Address - Fax:712-662-3297
Practice Address - Street 1:301 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:SAC CITY
Practice Address - State:IA
Practice Address - Zip Code:50583-2411
Practice Address - Country:US
Practice Address - Phone:712-662-7105
Practice Address - Fax:712-662-3297
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LORING HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-01-09
Last Update Date:2018-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0671727Medicaid
IA67172OtherBCBS HOME HEALTH
IA167172Medicare Oscar/Certification