Provider Demographics
NPI:1346308913
Name:LTC SERVICES, INC
Entity Type:Organization
Organization Name:LTC SERVICES, INC
Other - Org Name:LTC WHEELCHAIRS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:LORI
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:HULSEBUS
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:952-941-6800
Mailing Address - Street 1:5200 W 78TH ST
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55435-5303
Mailing Address - Country:US
Mailing Address - Phone:952-941-6800
Mailing Address - Fax:952-941-6006
Practice Address - Street 1:5200 W 78TH ST
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55435-5303
Practice Address - Country:US
Practice Address - Phone:952-941-6800
Practice Address - Fax:952-941-6006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1041562OtherPREFERREDONE#
MN165337OtherUCARE#
MN243K7LTOtherBLUECROSSBLUESHIELD#
MN97883OtherHEALTHPARTNERS#
MN82-00446OtherMEDICA#
MN1041562OtherPREFERREDONE#