Provider Demographics
NPI:1659524577
Name:LTC DISTRIBUTORS
Entity Type:Organization
Organization Name:LTC DISTRIBUTORS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:LAUBER
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:314-402-7900
Mailing Address - Street 1:11150 LINDBERGH BUSINESS CT STE 115
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63123-7832
Mailing Address - Country:US
Mailing Address - Phone:314-416-0903
Mailing Address - Fax:314-849-5654
Practice Address - Street 1:11150 LINDBERGH BUSINESS CT STE 115
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63123-7832
Practice Address - Country:US
Practice Address - Phone:314-416-0903
Practice Address - Fax:314-849-5654
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-23
Last Update Date:2008-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies