Provider Demographics
NPI:1578124921
Name:LMMC DES MOINES LLLP
Entity Type:Organization
Organization Name:LMMC DES MOINES LLLP
Other - Org Name:LIMITLESS MALE MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:BETH
Authorized Official - Middle Name:
Authorized Official - Last Name:HORVATICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-614-4969
Mailing Address - Street 1:1300 37TH ST STE 1
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-1900
Mailing Address - Country:US
Mailing Address - Phone:402-614-4969
Mailing Address - Fax:
Practice Address - Street 1:1300 37TH ST STE 1
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-1900
Practice Address - Country:US
Practice Address - Phone:402-614-4969
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LMMC DES MOINES LLLP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-06-26
Last Update Date:2020-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty