Organization
LONG TERM MEDICAL SUPPLY
Active
Parent organization
LONG TERM MEDICAL SUPPLY
Organization subpart
Yes
Provider details
NPI number
Legal business name
LONG TERM MEDICAL SUPPLY
Authorized official
MR. LARRY LINDLEY COO (CHIEF OPERATIONS OFFICER)
16414562885
Entity
Organization
Contact information
Practice address
929 BROAD ST, GRINNELL, IA 50112-2088
(641) 236-0608
(641) 236-0709
Mailing address
115 2ND AVE NW, HAMPTON, IA 50441-1723
(641) 456-2885
(641) 456-4482
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0480368
—
IA
01
—
25137
BLUE CROSS BLUE SHEID
IA
01
—
F243213
MIDLANDS
IA
Enumeration date
05/16/2006
Last updated
11/14/2007
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