NPIMap

Organization Active NPI

Lake Regional Health System

Doing business as Lake Regional Pharmacy - CMC

  • Pharmacy
  • Camdenton, MO
National Provider Identifier
1407960479
Registry record updated Jan 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
005731 Issued in MO
Legal business name
LAKE REGIONAL HEALTH SYSTEM
Doing business as
Lake Regional Pharmacy - CMC
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
Last updated
Jan 7, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2025

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

Authorized official

Name
Paula Sue Littleton
Title
Cfo
Phone
(573) 348-8388

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X 005731 MO Primary
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 names 1

  • LAKE REGIONAL PHARMACY - CMC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Lake of the Ozarks GH20 organizations share this tax ID, including this one

Other organizations with this tax ID 19

Organizations that report the same tax identification number in the National Provider Directory.

View all 19

Member of 1

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

Member organizations 5

Organizations listed as members of this organization in the National Provider Directory.

Locations

1930 N Business Route 5
#C
Camdenton, MO 65020
Phone (573) 346-2300

NPI Registry JSON

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736208000000",
    "number": "1407960479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1560",
            "city": "OSAGE BEACH",
            "state": "MO",
            "postal_code": "650651560",
            "telephone_number": "573-346-2300",
            "fax_number": "573-346-8409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1930-C NORTH BUSINESS ROUTE 5",
            "city": "CAMDENTON",
            "state": "MO",
            "postal_code": "650202659",
            "telephone_number": "573-346-2300",
            "fax_number": "573-346-8409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE REGIONAL HEALTH SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-18",
        "last_updated": "2025-01-07",
        "certification_date": "2025-01-07",
        "status": "A",
        "authorized_official_last_name": "LITTLETON",
        "authorized_official_first_name": "PAULA",
        "authorized_official_middle_name": "SUE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "573-348-8388"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "MO",
            "license": "005731",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LAKE REGIONAL PHARMACY - CMC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "LAKE REGIONAL PHARMACY - CMC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Camdenton, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2025; 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.