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

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 and National Provider Directory roles.

• Walgreen Co

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

  • 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
• 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.