Lamoni Varsity Drug L.L.C. D/B/a Varsity Drug

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

486 Issued in IA

Legal business name

LAMONI VARSITY DRUG L.L.C. D/B/A VARSITY DRUG

Practice address

101 E Main St
Lamoni, IA 50140-1241

Phone

(641) 784-6322

Fax

(641) 784-6415

NPI assigned

Dec 26, 2005

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Larry Stephen Phillips, R.PH.

Title

Owner

Phone

(641) 784-6322

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1135555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1194702738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 E MAIN ST",
            "city": "LAMONI",
            "state": "IA",
            "postal_code": "501401241",
            "telephone_number": "641-784-6322",
            "fax_number": "641-784-6415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 E MAIN ST",
            "city": "LAMONI",
            "state": "IA",
            "postal_code": "501401241",
            "telephone_number": "641-784-6322",
            "fax_number": "641-784-6415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAMONI VARSITY DRUG L.L.C. D/B/A VARSITY DRUG",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PHILLIPS",
        "authorized_official_first_name": "LARRY",
        "authorized_official_middle_name": "STEPHEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "641-784-6322",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "R.PH."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "IA",
            "license": "486",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0427393",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Lamoni Varsity Drug (Varisty Drug)
• Terry Burritt Lesan, DDS
• Erin Rae Lundy
• Ethan Middleton, PHARMD
• Andrew Miller, MAT, ATC, LAT
• Bryan Thomas Nowlin, DC

• Durable Medical Equipment & Medical Supplies in Lamoni, IA
• Providers in Lamoni, IA by specialty
• Durable Medical Equipment & Medical Supplies in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.