Organization Name: | THIES-LOMBARD PHARMACY, INC |
NPI Number: | 1467442673 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CRAIG GEORGE KUELTZO (PRESIDENT AND CEO) |
Mailing Address: | 805 S Main St Lombard |
State: | IL US |
Postal Code: | 601483300 |
Phone Number: | 6304952333 |
Fax Number: | 6304952355 |
NPI Enumeration Date: | 10/27/2005 |
NPI Last Update Date: | 04/20/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | 54-4487 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | IL |
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 |