Provider Demographics
NPI:1629728019
Name:LOOMIS PUBLIC SCHOOL
Entity Type:Organization
Organization Name:LOOMIS PUBLIC SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:
Authorized Official - First Name:SAM
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:DUNN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:308-876-2111
Mailing Address - Street 1:101 BRYAN ST # 250
Mailing Address - Street 2:
Mailing Address - City:LOOMIS
Mailing Address - State:NE
Mailing Address - Zip Code:68958-1806
Mailing Address - Country:US
Mailing Address - Phone:308-876-2111
Mailing Address - Fax:308-876-2372
Practice Address - Street 1:101 BRYAN ST # 250
Practice Address - Street 2:
Practice Address - City:LOOMIS
Practice Address - State:NE
Practice Address - Zip Code:68958-1806
Practice Address - Country:US
Practice Address - Phone:308-876-2111
Practice Address - Fax:308-876-2372
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-28
Last Update Date:2022-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization