NPIMap

Organization Active NPI

LTC Providers, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Sullivan, MO
National Provider Identifier
1396865663
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
15522814 Issued in MO
Legal business name
LTC PROVIDERS, INC.
Practice address
115 Progress Pkwy
Sullivan, MO 63080-2359
Phone
(573) 860-6800
Fax
(573) 860-6801
NPI assigned
Mar 30, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Jeffrey D Lock
Title
President Owner
Phone
(573) 860-6800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 15522814 MO Primary

Addresses

Primary practice location

115 Progress Pkwy
Sullivan, MO 63080-2359

Mailing address

PO Box 69
Sullivan, MO 63080-0069
Phone (573) 860-6800

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1396865663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 69",
            "city": "SULLIVAN",
            "state": "MO",
            "postal_code": "630800069",
            "telephone_number": "573-860-6800",
            "fax_number": "573-860-6801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 PROGRESS PKWY",
            "city": "SULLIVAN",
            "state": "MO",
            "postal_code": "630802359",
            "telephone_number": "573-860-6800",
            "fax_number": "573-860-6801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LTC PROVIDERS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LOCK",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT OWNER",
        "authorized_official_telephone_number": "573-860-6800",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MO",
            "license": "15522814",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sullivan, MO

Sources for this page

  • 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.