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NPI Code Detail

MEDICARE: LAKE REGIONAL HEALTH SYSTEM

MEDICARE: LAKE REGIONAL HEALTH SYSTEM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1332B00000XDurable Medical Equipment & Medical Supplies
23336C0003XCommunity/Retail Pharmacy
33336C0004XCompounding Pharmacy
43336L0003XLong Term Care Pharmacy
5333600000XPharmacy005731MO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
22047179OTHERPK

General Provider Information

NPI Number : 1407960479
Entity Type Code : Organization
Provider Name (Legal Business Name) : LAKE REGIONAL HEALTH SYSTEM
Provider Business Mailing Address
First Line : PO BOX 1560
Second Line :
City : OSAGE BEACH
State : MO
Zip : 65065-1560
Country : US
Telephone Number : 573-346-2300
Fax Number : 573-346-8409
Provider Business Practice Location Address
First Line : 1930-C NORTH BUSINESS ROUTE 5
Second Line :
City : CAMDENTON
State : MO
Zip : 65020-2659
Country : US
Telephone Number : 573-346-2300
Fax Number : 573-346-8409
Authorized Official
Title or Position : CFO
Name : PAULA SUE LITTLETON
Credential :
Telephone Number : 573-348-8388
Provider Enumeration Date : 08/18/2006
Last Update Date : 01/07/2025

Similar Medicare Providers

1477552479 — DR. MICHAEL H LEDBETTER DO
Practice Location Address:
1930 N BUSINESS ROUTE 5 , UNIT 1A
CAMDENTON, MO
65020-2659
Practice Phone: 573-346-5624
Practice Fax: 573-346-1957
1548242894 — CAROLINE ELIZABETH CAMPBELL M.D.
Practice Location Address:
1930 N BUSINESS ROUTE 5
CAMDENTON, MO
65020-2659
Practice Phone: 573-346-5624
Practice Fax: 573-346-1957
1013997493 — DR. LINDA S JABBARI DO
Practice Location Address:
1930 N BUSINESS ROUTE 5 , UNIT 1A
CAMDENTON, MO
65020-2659
Practice Phone: 573-346-5624
Practice Fax: 573-346-1957
1548434384 — DR. SHARI LEUWERKE NEILL MD
Practice Location Address:
1930 N BUSINESS ROUTE 5 , UNIT 1A
CAMDENTON, MO
65020-2659
Practice Phone: 573-346-5624
Practice Fax: 573-346-1957
1013181601 — JAMES J.L. NEILL M.D.
Practice Location Address:
1930 N BUSINESS ROUTE 5 , UNIT 1A
CAMDENTON, MO
65020-2659
Practice Phone: 573-346-5624
Practice Fax: 573-346-1957
1669775771 — ROBERT OLIVER MEYER FNP
Practice Location Address:
1930 N BUSINESS ROUTE 5 , UNIT 1A
CAMDENTON, MO
65020-2659
Practice Phone: 573-346-5624
Practice Fax: 573-346-1957

Directions to “LAKE REGIONAL HEALTH SYSTEM ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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