Lake Country Medical Supplies of Okmulgee, LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

LAKE COUNTRY MEDICAL SUPPLIES OF OKMULGEE, LLC

Practice address

1180 S Belmont Ave
Okmulgee, OK 74447-6308

Phone

(918) 756-9279

Fax

(918) 756-2656

NPI assigned

May 27, 2005

Organization subpart

No

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

Authorized official

Name

Ryan Ritter, D.P.H.

Title

Owner President

Phone

(580) 889-7800

Specialties & licenses 5

Addresses

Other identifiers 1

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

{
    "created_epoch": "1117152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1306368000000",
    "number": "1376546960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 S MISSISSIPPI AVE",
            "city": "ATOKA",
            "state": "OK",
            "postal_code": "745253324",
            "telephone_number": "580-889-7878",
            "fax_number": "580-889-8713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1180 S BELMONT AVE",
            "city": "OKMULGEE",
            "state": "OK",
            "postal_code": "744476308",
            "telephone_number": "918-756-9279",
            "fax_number": "918-756-2656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE COUNTRY MEDICAL SUPPLIES OF OKMULGEE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-27",
        "last_updated": "2011-05-26",
        "status": "A",
        "authorized_official_last_name": "RITTER",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "OWNER PRESIDENT",
        "authorized_official_telephone_number": "580-889-7800",
        "authorized_official_credential": "D.P.H."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "OK",
            "license": null,
            "primary": true
        },
        {
            "code": "332BD1200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Dialysis Equipment & Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BN1400X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Nursing Facility Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "OK",
            "license": "14-S-795",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100812630A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Debra Kelley, RN
• Truman Keith Keplinger, LPC
• Ky Joel Kiger, P.T.
• Randy Knight, DPHARM
• Stephanie Laird
• Andrew Steven Lambert, DMD
• Brittney Dawn Larney- McCarroll
• Larry C Christy DDS Inc
• Constance Lashmet
• Hollie Ledford, MSW

• Durable Medical Equipment & Medical Supplies in Okmulgee, OK
• Providers in Okmulgee, OK by specialty
• Durable Medical Equipment & Medical Supplies in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 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.