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General NPI Number Information
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NPI Number | 1386926939
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Entity Type | Organization
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Legal Business Name | LAKE REGIONAL HEALTH SYSTEM
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Dates
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Enumeration Date | 09/09/2011
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Last Update Date | 05/23/2025
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Provider Practice Location Address
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Address Line | 1075 NICHOLS RD SUITE 1-2
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City | OSAGE BEACH
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State | MO
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Zip | 65065-3093
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Country | US
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Telephone | 573-302-2828
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Fax | 573-302-2830
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Provider Business Mailing Address
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Address Line | PO BOX 801661
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City | KANSAS CITY
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State | MO
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Zip | 64180-1661
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Country | US
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Telephone | 573-348-8000
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | PAULA SUE LITTLETON
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Credential |
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Telephone | 573-348-8388
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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