LAKE REGIONAL MEDICAL MANAGEMENT, INC. (NPI# 1407960479) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407960479 |
| Entity Type | Organization |
| Organization Name | LAKE REGIONAL MEDICAL MANAGEMENT, INC. |
| Other Organization Name | LAKE REGIONAL PHARMACY - CMC |
| Practice Address |
1930-c North Business Route 5 Camdenton MO 65020-2659 |
| Mailing Address |
Po Box 1560 Osage Beach MO 65065-1560 |
| Practice Telephone | 5733462300 |
| Practice Fax Number | 5733468409 |
| Mailing Telephone | 5733462300 |
| Mailing Fax Number | 5733468409 |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2017-01-26 |
| Authorized Official Name | STACIE LING (DIRECTOR) |
| Authorized Official Telephone | 5733023185 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
Suppliers | ||
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers | ||
| N | 3336C0004X |
Pharmacy Specialization: Compounding Pharmacy |
Suppliers | ||
| Y | 333600000X | Pharmacy | 005731 | MO | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2047179 | 01 | |
| MO | 600054704 | 05 |
| Other Name | Type Code |
|---|---|
| LAKE REGIONAL PHARMACY - CMC | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780116657 | Lake Regional Medical Management, Inc. | Pharmacy | 416b S Maple St, Eldon, MO 65026-1812 | 2017-03-30 |
| 1154701803 | Lake Regional Medical Management, Inc. | Durable Medical Equipment & Medical Supplies | 54 Hospital Dr, Suite 213, Osage Beach, MO 65065-3050 | 2015-06-08 |
| 1609273259 | Lake Regional Medical Management, Inc. | Durable Medical Equipment & Medical Supplies | 1075 Nichols Rd, Suite 7-8, Osage Beach, MO 65065-3093 | 2014-11-25 |
| 1386926939 | Lake Regional Medical Management, Inc. | Durable Medical Equipment & Medical Supplies | 1075 Nichols Rd, Suite 1-2, Osage Beach, MO 65065-3093 | 2011-09-09 |
| 1174814545 | Lake Regional Medical Management, Inc. | Clinic/Center | 5816 Hwy 54, Suite 111, Osage Beach, MO 65065-3046 | 2011-04-20 |
| 1598882656 | Lake Regional Medical Management, Inc. | Durable Medical Equipment & Medical Supplies | 1075 Nichols Rd, Suite 3-4, Osage Beach, MO 65065-3093 | 2007-03-23 |
| 1639134158 | Lake Regional Medical Management, Inc. | Clinic/Center | 54 Hospital Dr, Osage Beach, MO 65065-3050 | 2006-04-18 |
| Street Address |
1930-C NORTH BUSINESS ROUTE 5 |
| City | CAMDENTON |
| State | MO |
| Zip Code | 65020-2659 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295383024 | Carinda Elynn Steele | Physical Therapy Assistant | 1930 N Business 5, Camdenton, MO 65020 | 2019-08-26 |
| 1831651660 | Erin Elisabeth Sluyter | Physician Assistant | 1652 North Business Route 5, Camdenton, MO 65020 | 2019-04-01 |
| 1922575125 | Serene Shores, LLC | Counselor | 75 Court Circle Se, Camdenton, MO 65020 | 2018-10-26 |
| 1902396591 | Audrey Dawn Sheppard | Counselor | 89 Mccrory Dr, Camdenton, MO 65020 | 2018-05-18 |
| 1427586072 | Abc Laurie LLC | Chiropractor | 139 E Hwy 54 Suite 1c, Camdenton, MO 65020 | 2017-05-26 |
| 1891229878 | Benton Street Counseling LLC | Counselor | 89 Mccrory Drive, Camdenton, MO 65020 | 2017-04-17 |
| 1033658463 | Erica L Asbell | Social Worker | 172 Dare Blvd., Camdenton, MO 65020 | 2017-02-17 |
| 1376816967 | Linda Susan Sheriff | Speech-Language Pathologist | 158 Minor Street, Camdenton, MO 65020 | 2012-02-14 |
| 1285902031 | Gregory Ryan Boren | Pharmacist | 72 South Business Route 5, Camdenton, MO 65020 | 2011-12-08 |
| 1265757033 | Abcs of Wellness, LLC | Chiropractor | 139 E. Hwy 54, 1c, Camdenton, MO 65020 | 2010-04-05 |
| Find all providers in zip 65020 | ||||
| Taxonomy Code | 333600000X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235291121 | M.w.allen Pharmacy Inc. | Pharmacy | 932 N State Highway 5, Camdenton, MO 65020-2648 | 2006-12-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912506437 | E Health Pharmacy, LLC | Pharmacy | 411d Northview Rd, Nixa, MO 65714-8679 | 2020-10-26 |
| 1750994869 | Script Partner Pharmacy LLC | Pharmacy | 100 Chesterfield Bus Pkwy Ste 279, Chesterfield, MO 63005-1271 | 2020-08-28 |
| 1821600545 | Debbie S Pharmacy LLC | Pharmacy | 815 Hazelwest Dr Ste 100, Hazelwood, MO 63042-1762 | 2020-08-24 |
| 1689285082 | Logan & Seiler Inc | Pharmacy | 102 Hospitality Drive, Suite B, Sikeston, MO 63801 | 2020-08-11 |
| 1023626389 | Lemonaid Community Pharmacy, Inc | Pharmacy | 7580 Watson Rd, Saint Louis, MO 63119-4409 | 2020-07-22 |
| 1689207870 | Washington University Cancer Center Pharmacy - North County | Pharmacy | 1225 Graham Rd Fl 1, Florissant, MO 63031-8012 | 2020-02-17 |
| 1942847413 | Southeast Hospital | Pharmacy | 2600 E. Main Street, Suite 113, Jackson, MO 63755 | 2019-12-04 |
| 1720624323 | Toney Drug & Wellness, LLC | Pharmacy | #1 Hals Plaza Dr, Piedmont, MO 63957 | 2019-11-19 |
| 1427606912 | Medley Pharmacy Inc | Pharmacy | 1024 S Bishop Ave, Rolla, MO 65401-4416 | 2019-08-28 |
| 1013479716 | Cerner Health Connections, Inc. | Pharmacy | 1403 Hampton Avenue, St. Louis, MO 63139 | 2019-04-02 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.