# REGINA M LASSABE

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Family Medical Supply
- **Organization subpart:** No

## Provider details

- **NPI number:** 1124479001
- **Authorized official:** REGINA M LASSABE (OWNER)
- **Authorized official phone:** (641) 216-8217

## Contact information

- **Practice address:** 209 E MAPLE ST, STE 6, CENTERVILLE, IA 52544-2200
- **Practice address phone:** (641) 216-8217
- **Practice address fax:** (641) 216-8218
- **Mailing address:** 209 E MAPLE ST, STE 6, CENTERVILLE, IA 52544-2200
- **Mailing address phone:** (641) 216-8217
- **Mailing address fax:** (641) 216-8218

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332BX2000X | Oxygen Equipment & Supplies (DME) | 104007626 | IA | Yes |

## Other

- **Enumeration date:** 06/22/2016
- **Last updated:** 06/22/2016