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NPI Code Detail

MEDICARE: LAKE COUNTRY MEDICAL BILLING LLC

MEDICARE: LAKE COUNTRY MEDICAL BILLING LLC
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

General Provider Information

NPI Number : 1871092072
Entity Type Code : Organization
Provider Name (Legal Business Name) : LAKE COUNTRY MEDICAL BILLING LLC
Provider Business Mailing Address
First Line : PO BOX 870
Second Line :
City : ATOKA
State : OK
Zip : 74525-0870
Country : US
Telephone Number : 580-889-0230
Fax Number :
Provider Business Practice Location Address
First Line : 744 S MISSISSIPPI AVE
Second Line :
City : ATOKA
State : OK
Zip : 74525-3355
Country : US
Telephone Number : 580-889-2101
Fax Number :
Authorized Official
Title or Position : OWNER
Name : RYAN RITTER
Credential :
Telephone Number : 580-889-0230
Provider Enumeration Date : 02/03/2018
Last Update Date : 02/03/2018

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Directions to “LAKE COUNTRY MEDICAL BILLING LLC ” Practice Location

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