Lake Regional Health System
Organization Active NPI Pharmacy · Camdenton, MO
NPI 1407960479 · NPPES record last updated Jan 7, 2025
Key facts
- NPI
- 1407960479
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pharmacy 333600000X
- License
- 005731 (MO)
- Legal business name
- LAKE REGIONAL HEALTH SYSTEM
- Practice address
- 1930-C North Business Route 5
Camdenton, MO 65020-2659 - Phone
- (573) 346-2300
- Fax
- (573) 346-8409
- NPI assigned
- Aug 18, 2006
- Organization subpart
- No
Authorized official
- Name
- Paula Sue Littleton
- Title
- Cfo
- Phone
- (573) 348-8388
Corporate family (same tax ID) 19
Member of 1
National Provider Directory
- Tax ID family
- Lake of the Ozarks Gene
Locations
1930 N Business Route 5
#C
Camdenton, MO 65020
Phone (573) 346-2300
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Pharmacy | 333600000X | 005731 | MO | Yes |
| Community/Retail Pharmacy | 3336C0003X | |||
| Compounding Pharmacy | 3336C0004X | |||
| Long Term Care Pharmacy | 3336L0003X |
Addresses
Primary practice location
1930-C North Business Route 5
Camdenton, MO 65020-2659
Mailing address
PO Box 1560
Osage Beach, MO 65065-1560
Phone (573) 346-2300
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 600054704 | Medicaid | MO | |
| 2047179 | Other | PK |
Other names
- LAKE REGIONAL PHARMACY - CMC
Other providers in Camdenton, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 7, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.