Provider Demographics
NPI:1144944190
Name:DONIPHAN-TRUMBULL SCHOOL
Entity type:Organization
Organization Name:DONIPHAN-TRUMBULL SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:GRETCHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:BECK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-845-2282
Mailing Address - Street 1:302 W. PLUM ST., PO BOX 300
Mailing Address - Street 2:
Mailing Address - City:DONIPHAN
Mailing Address - State:NE
Mailing Address - Zip Code:68832
Mailing Address - Country:US
Mailing Address - Phone:402-845-2282
Mailing Address - Fax:402-845-6688
Practice Address - Street 1:302 W. PLUM ST.,
Practice Address - Street 2:
Practice Address - City:DONIPHAN
Practice Address - State:NE
Practice Address - Zip Code:68832
Practice Address - Country:US
Practice Address - Phone:402-845-2282
Practice Address - Fax:402-845-6688
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-03
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10026732600Medicaid