Provider Demographics
NPI:1548544216
Name:LONG TERM MEDICAL SUPPLY CORP
Entity type:Organization
Organization Name:LONG TERM MEDICAL SUPPLY CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HR
Authorized Official - Prefix:MR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:R
Authorized Official - Last Name:ALLBEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:641-456-5636
Mailing Address - Street 1:126 N HOWARD ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:INDIANOLA
Mailing Address - State:IA
Mailing Address - Zip Code:50125-2562
Mailing Address - Country:US
Mailing Address - Phone:515-962-2198
Mailing Address - Fax:515-962-2085
Practice Address - Street 1:126 N HOWARD ST
Practice Address - Street 2:SUITE 102
Practice Address - City:INDIANOLA
Practice Address - State:IA
Practice Address - Zip Code:50125
Practice Address - Country:US
Practice Address - Phone:641-456-2885
Practice Address - Fax:515-962-2085
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-29
Last Update Date:2015-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA191010836332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies