Lake Regional Pharmacy - Eldon
LBN: Lake Regional Medical Management, Inc.
Lake Regional Pharmacy - Eldon is an health care organization with primary practice located at 416B S Maple St , Eldon MO 65026-1812. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy, Suppliers / Long Term Care Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty.
Lake Regional Medical Management, Inc. can be contacted via phone (573) 557-2231, or through Mcroberts, Kevin via phone (573) 348-8756.
Contact Information
Primary practice address
416B S Maple St
Eldon MO 65026-1812
Phone: (573) 557-2231
Fax: (573) 392-5808
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Pharmacy | 333600000X | ||
| Suppliers / Community/Retail Pharmacy | 3336C0003X | 2017025596 | Missouri |
| Suppliers / Long Term Care Pharmacy | 3336L0003X |
Profile Details
| NPI number | 1780116657 |
|---|---|
| LBN Legal business name | Lake Regional Medical Management, Inc. |
| DBA Doing business as | Lake Regional Pharmacy - Eldon |
| Authorized official | Mcroberts, Kevin |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Mar 30th, 2017 |
| Last updated | Oct 16th, 2023 - about 2 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1780116657 | NPPES |
| Missouri | MEDICAID | 600045506 | |
| Missouri | Other | 2168691 |
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