Provider Demographics
NPI:1134561939
Name:LANKFORD HOLDINGS MONOGRAM, INC
Entity type:Organization
Organization Name:LANKFORD HOLDINGS MONOGRAM, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:LANKFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:623-581-8998
Mailing Address - Street 1:19875 N 51ST AVE
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-5114
Mailing Address - Country:US
Mailing Address - Phone:623-581-8998
Mailing Address - Fax:623-581-6461
Practice Address - Street 1:19875 N 51ST AVE
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-5114
Practice Address - Country:US
Practice Address - Phone:623-581-8998
Practice Address - Fax:623-581-6461
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-22
Last Update Date:2013-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site