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Contact Information

LETASSY HEALTH SERVICES
1002 W PINE ST
POPLAR BLUFF, MO63901-4840
 Phone: 573-785-0048
 Fax: 573-785-0459
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Long Term Care Pharmacy

3336L0003X 58 Medical Supply Company with Pharmacist
 

Nursing Facility Supplies

332BN1400X 87 All Other Suppliers
 

Public Health or Welfare

251K00000X 60 Public Health or Welfare Agency
Indicates primary specialty

NPI Profile & details for LETASSY HEALTH SERVICES

NPI # 1780603969
LBN Legal business name LETASSY HEALTH SERVICES
Authorized official DAVID LETASSY - (RPH)
Entity Organization
Organization subpart 1 No
Enumeration date 07/19/2006
Last updated 10/08/2009 - About 17 years ago
Identifiers
MO License # 004918
MO License # 622577708
MO License # 854887502
MO Medicaid 602577702
MO Medicaid 622577708
MO Medicaid 854887502
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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