Organization
LAMONI VARSITY DRUG L.L.C. D/B/A VARSITY DRUG
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LARRY STEPHEN PHILLIPS R.PH. (OWNER)
(641) 784-6322
Entity
Organization
Contact information
Practice address
101 E MAIN ST, LAMONI, IA 50140-1241
(641) 784-6322
(641) 784-6415
Mailing address
101 E MAIN ST, LAMONI, IA 50140-1241
(641) 784-6322
(641) 784-6415
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
486
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0427393
—
IA
Enumeration date
12/26/2005
Last updated
08/22/2020
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