Provider Demographics
NPI:1881646065
Name:LONG TERM MEDICAL SUPPLY
Entity Type:Organization
Organization Name:LONG TERM MEDICAL SUPPLY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATIONS OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:LINDLEY
Authorized Official - Suffix:
Authorized Official - Credentials:COO
Authorized Official - Phone:1641-456-2885
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 1:929 BROAD ST
Practice Address - Street 2:
Practice Address - City:GRINNELL
Practice Address - State:IA
Practice Address - Zip Code:50112-2088
Practice Address - Country:US
Practice Address - Phone:641-236-0608
Practice Address - Fax:641-236-0709
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LONG TERM MEDICAL SUPPLY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-16
Last Update Date:2007-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAF243213OtherMIDLANDS
IA0480368Medicaid
IA25137OtherBLUE CROSS BLUE SHEID
IA25137OtherBLUE CROSS BLUE SHEID