Mountain Lakes Medical Supply Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

102727 Issued in CA

Legal business name

MOUNTAIN LAKES MEDICAL SUPPLY INC

Practice address

226 E. Fairway Blvd
Big Bear City, CA 92314-9050

Phone

(909) 585-1339

Fax

(909) 585-3646

NPI assigned

Oct 18, 2006

Organization subpart

No

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

Authorized official

Name

Marc K Lapham, RCPNPI 1689837395

Title

Owner Operator

Phone

(909) 585-1339

Specialties & licenses 1

Addresses

Other identifiers 2

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Marc K Lapham, CRTT

  • Certified Respiratory Therapist
  • Big Bear City, CA
  • NPI 1689837395
  NPD (past) Authorized official

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216339200000",
    "number": "1639250046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1679",
            "city": "BIG BEAR CITY",
            "state": "CA",
            "postal_code": "923149050",
            "telephone_number": "909-585-1339",
            "fax_number": "909-585-3646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "226 E. FAIRWAY BLVD",
            "city": "BIG BEAR CITY",
            "state": "CA",
            "postal_code": "923149050",
            "telephone_number": "909-585-1339",
            "fax_number": "909-585-3646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN LAKES MEDICAL SUPPLY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-18",
        "last_updated": "2008-07-18",
        "status": "A",
        "authorized_official_last_name": "LAPHAM",
        "authorized_official_first_name": "MARC",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER OPERATOR",
        "authorized_official_telephone_number": "909-585-1339",
        "authorized_official_credential": "RCP"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CA",
            "license": "102727",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SUBMITTER ID",
            "identifier": "D08601548",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DME01937F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lactation Consultants of America
• Marc K Lapham, CRTT
• Renee Lara Marquez
• Ashley Marshall
• Erin Elizabeth Morini, MPH, RD, LDN
• Rosie A Nakada
• Odyssey Nutrition LLC
• Pom Pom Speech & Language Therapy, Inc.
• Calvin P Pramann, D.C.
• PRN Health Coach LLC

• Durable Medical Equipment & Medical Supplies in Big Bear City, CA
• Providers in Big Bear City, CA by specialty
• Durable Medical Equipment & Medical Supplies in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2008; 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.