Organization
LETASSY HEALTH SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID T LETASSY (RPH)
(573) 785-0048
Entity
Organization
Contact information
Practice address
1002 W PINE ST, POPLAR BLUFF, MO 63901-4840
(573) 785-0048
(573) 785-0459
Mailing address
1002 W PINE ST, POPLAR BLUFF, MO 63901-4840
(573) 785-0048
(573) 785-0459
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
854887502
MO
332BN1400X
Nursing Facility Supplies (DME)
622577708
MO
3336L0003X
Long Term Care Pharmacy
Primary
004918
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
602577702
—
MO
05
—
622577708
—
MO
05
—
854887502
—
MO
Enumeration date
07/19/2006
Last updated
10/08/2009
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