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General NPI Number Information
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NPI Number | 1023691771
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Entity Type | Organization
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Legal Business Name | LCS-MW LLC
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Dates
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Enumeration Date | 04/30/2021
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Last Update Date | 04/30/2021
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Provider Practice Location Address
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Address Line | 5114 MCKINNEY AVE
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City | DALLAS
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State | TX
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Zip | 75205-3327
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Country | US
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Telephone | 214-528-0660
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Fax |
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Provider Business Mailing Address
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Address Line | 400 LOCUST ST STE 820
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City | DES MOINES
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State | IA
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Zip | 50309-2334
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Country | US
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Telephone | 515-875-4520
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE VP AND SECRETARY
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Name | DIANE BRIDGEWATER
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Credential |
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Telephone | 515-875-4768
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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