Lance Lake, RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

2001010937 Issued in MO

Practice address

1675 W South St
Ozark, MO 65721-5152

Phone

(417) 485-0762

Fax

(417) 485-0793

NPI assigned

Aug 27, 2011

Last updated

Aug 27, 2011By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Walgreen Co

  dba Walgreens #9929

  • Pharmacy
  • Ozark, MO
  • NPI 1508949066
  NPD (past)
• Walgreen Co

  dba Walgreens #21605

  • Pharmacy
  • Longview, TX
  • NPI 1629956545
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1314403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314403200000",
    "number": "1003196569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1675 W SOUTH ST",
            "city": "OZARK",
            "state": "MO",
            "postal_code": "657215152",
            "telephone_number": "417-485-0762",
            "fax_number": "417-485-0793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1675 W SOUTH ST",
            "city": "OZARK",
            "state": "MO",
            "postal_code": "657215152",
            "telephone_number": "417-485-0762",
            "fax_number": "417-485-0793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAKE",
        "first_name": "LANCE",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-08-27",
        "last_updated": "2011-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MO",
            "license": "2001010937",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "SD",
            "license": "4847",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joshua Kenneth Knapton, DMD
• Valerie Knight
• Kendon Kelly Knowles, DMD
• Katrina Kovarik-Stevens, CPNP
• KPBN Apothecary LLC (Lawrence Drug)
• Ashley R Lamb, PLPC
• Sheri Andrews Lammert
• Callie Langley
• Shelby Lea Laughlin, MD
• Haylee Leavitt-Kirkland

• Pharmacist in Ozark, MO
• Providers in Ozark, MO by specialty
• Pharmacist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.