Provider Demographics
NPI:1528372562
Name:LOUP BASIN PUBLIC HEALTH DEPARTMENT
Entity Type:Organization
Organization Name:LOUP BASIN PUBLIC HEALTH DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:A
Authorized Official - Last Name:CONE
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:308-346-5795
Mailing Address - Street 1:P.O. BOX 995
Mailing Address - Street 2:295 NORTH 8TH AVE
Mailing Address - City:BURWELL
Mailing Address - State:NE
Mailing Address - Zip Code:68823
Mailing Address - Country:US
Mailing Address - Phone:308-346-5795
Mailing Address - Fax:308-346-9106
Practice Address - Street 1:295 N 8TH AVE
Practice Address - Street 2:
Practice Address - City:BURWELL
Practice Address - State:NE
Practice Address - Zip Code:68823-4168
Practice Address - Country:US
Practice Address - Phone:308-346-5795
Practice Address - Fax:308-346-9106
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-02
Last Update Date:2010-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or Local