Provider Demographics
NPI:1508558966
Name:COUNTY OF CUSTER SCHOOL DISTRICT #84
Entity Type:Organization
Organization Name:COUNTY OF CUSTER SCHOOL DISTRICT #84
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOOK KEEPER
Authorized Official - Prefix:
Authorized Official - First Name:HOLLI
Authorized Official - Middle Name:A
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:308-527-4119
Mailing Address - Street 1:PO BOX 366
Mailing Address - Street 2:
Mailing Address - City:SARGENT
Mailing Address - State:NE
Mailing Address - Zip Code:68874-0366
Mailing Address - Country:US
Mailing Address - Phone:308-527-4119
Mailing Address - Fax:
Practice Address - Street 1:400 N 5TH ST
Practice Address - Street 2:
Practice Address - City:SARGENT
Practice Address - State:NE
Practice Address - Zip Code:68874-6104
Practice Address - Country:US
Practice Address - Phone:308-527-4119
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-24
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health