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General NPI Number Information
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NPI Number | 1881646065
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Entity Type | Organization
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Legal Business Name | LONG TERM MEDICAL SUPPLY
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Dates
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Enumeration Date | 05/16/2006
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Last Update Date | 11/14/2007
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Provider Practice Location Address
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Address Line | 929 BROAD ST
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City | GRINNELL
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State | IA
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Zip | 50112-2088
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Country | US
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Telephone | 641-236-0608
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Fax | 641-236-0709
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Provider Business Mailing Address
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Address Line | 115 2ND AVE NW
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City | HAMPTON
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State | IA
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Zip | 50441-1723
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Country | US
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Telephone | 641-456-2885
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Fax | 641-456-4482
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Authorized Official
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Title or Position | CHIEF OPERATIONS OFFICER
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Name | MR. LARRY LINDLEY
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Credential | COO
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Telephone | 16414562885
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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