Organization Name: | LAMONI VARSITY DRUG L.L.C. D/B/A VARSITY DRUG |
NPI Number: | 1194702738 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | LARRY STEPHEN PHILLIPS (OWNER) |
Mailing Address: | 101 E Main St Lamoni |
State: | IA US |
Postal Code: | 501401241 |
Phone Number: | 6417846322 |
Fax Number: | 6417846415 |
NPI Enumeration Date: | 12/26/2005 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | 486 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IA |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | |
Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |