Provider Demographics
NPI:1497796122
Name:LONG TERM MEDICAL SUPPLY CORPORATION
Entity Type:Organization
Organization Name:LONG TERM MEDICAL SUPPLY CORPORATION
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 1:115 2ND AVE NW
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:IA
Mailing Address - Zip Code:50441-1723
Mailing Address - Country:US
Mailing Address - Phone:641-456-2885
Mailing Address - Fax:641-456-4482
Practice Address - Street 1:107 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:IA
Practice Address - Zip Code:52057-1736
Practice Address - Country:US
Practice Address - Phone:563-927-3836
Practice Address - Fax:563-927-3839
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LONG TERM MEDICAL SUPPLY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-10
Last Update Date:2015-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0177610007Medicare NSC
IA25137OtherBLUE CROSS BLUE SHIELD
IAF243213OtherMIDLANDS CHOICE