Lakeshore Medical Clinic, LTD

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

LAKESHORE MEDICAL CLINIC, LTD

Practice address

2424 S 90TH St
West Allis, WI 53227-2455

Phone

(414) 328-8777

NPI assigned

Jun 20, 2007

Last updated

Jul 29, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Masood Wasiullah, MD

Title

President

Phone

(414) 389-2377

Specialties & licenses 1

Addresses

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Aurora Medical Group, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Hustisford, WI
  • NPI 1528193174

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1182297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1248825600000",
    "number": "1215132055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2424 S 90TH ST",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532272455",
            "telephone_number": "414-328-8777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2424 S 90TH ST",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532272455",
            "telephone_number": "414-328-8777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESHORE MEDICAL CLINIC, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-20",
        "last_updated": "2009-07-29",
        "status": "A",
        "authorized_official_last_name": "WASIULLAH",
        "authorized_official_first_name": "MASOOD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "414-389-2377",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laurie A Lacoursiere, RD
• Shanon Renee Lacy, D.O.
• John Laczkowski, OD
• Tammy Laduron, LPN
• Valerie June Lake, RN
• Lakeshore Medical Clinic, LTD.
• Lakeside Senior Living LLC (Honey Creek Heights Senior Living)
• Aimee C Laliberte-Brown, RN
• Amy Peters Lalios, M.A., CCC-A
• Anna M Lamnari, MD

• Durable Medical Equipment & Medical Supplies in West Allis, WI
• Providers in West Allis, WI by specialty
• Durable Medical Equipment & Medical Supplies in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2009; 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.