Provider Demographics
NPI:1356659916
Name:TAMMY LOOSMAN LLC
Entity Type:Organization
Organization Name:TAMMY LOOSMAN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETER
Authorized Official - Prefix:
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:KOOSMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-689-4813
Mailing Address - Street 1:140 EMERSON ST S
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MN
Mailing Address - Zip Code:55008-1728
Mailing Address - Country:US
Mailing Address - Phone:763-689-4813
Mailing Address - Fax:763-689-4813
Practice Address - Street 1:140 EMERSON ST S
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MN
Practice Address - Zip Code:55008-1728
Practice Address - Country:US
Practice Address - Phone:763-689-4813
Practice Address - Fax:763-689-4813
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-16
Last Update Date:2010-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health