Healthcare Provider Details

I. General information

NPI: 1538114350
Provider Name (Legal Business Name): TOPKO OF DENISON INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2006
Last Update Date: 01/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 BROADWAY
DENISON IA
51442
US

IV. Provider business mailing address

1401 BROADWAY
DENISON IA
51442
US

V. Phone/Fax

Practice location:
  • Phone: 712-263-8464
  • Fax: 712-263-2430
Mailing address:
  • Phone: 712-263-8464
  • Fax: 712-263-2430

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number StateIA
# 3
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number428
License Number StateIA

VIII. Authorized Official

Name: MRS. TRISHA LYNN BENNING
Title or Position: OFFICE MANAGER
Credential:
Phone: 712-263-8464