MEDICARE: MASON THOMAS LOVGREN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	372500000X	Chore Provider
2	3747P1801X	Personal Care Attendant
3	372600000X	Adult Companion

General Provider Information

NPI Number	:	1083505515
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MASON THOMAS LOVGREN

Provider Business Mailing Address
First Line	:	1440 S 158TH CIR
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68130-2523
Country	:	US
Telephone Number	:	402-740-0120
Fax Number	:

Provider Business Practice Location Address
First Line	:	16512 POPPLETON AVE
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68130-1356
Country	:	US
Telephone Number	:	402-740-0120
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/12/2025
Last Update Date	:	07/12/2025

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Directions to “ MASON THOMAS LOVGREN ” Practice Location

Language	Start Address	Practice Location

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