Lakeshore Medical Supplies, Inc.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

LAKESHORE MEDICAL SUPPLIES, INC.

Practice address

9550 Forest LN
Suite 102
Dallas, TX 75243-5905

Phone

(214) 348-9700

Fax

(214) 348-9701

NPI assigned

Dec 5, 2007

Last updated

Aug 27, 2008By 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

Anthony E Nwedo

Title

President

Phone

(469) 855-2279

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

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

{
    "created_epoch": "1196812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219795200000",
    "number": "1760665301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9550 FOREST LN",
            "address_2": "SUITE 102",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752435905",
            "telephone_number": "214-348-9700",
            "fax_number": "214-348-9701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9550 FOREST LN",
            "address_2": "SUITE 102",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752435905",
            "telephone_number": "214-348-9700",
            "fax_number": "214-348-9701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESHORE MEDICAL SUPPLIES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-05",
        "last_updated": "2008-08-27",
        "status": "A",
        "authorized_official_last_name": "NWEDO",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "469-855-2279"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly J Lake, DDS
• Lakehill Preparatory School: Health and Wellness Center
• Lakeshia Kijuan Ealy (Gentle Hands Home Health Care)
• Lakeshore Anesthesia Group, PLLC
• Lakeshore Healthcare Services, Inc.
• Lakeview ENT, PA
• Lakeview Health Solutions, PLLC
• Lakeview Primary Homecare LLC
• Lakewood Anesthesia, PLLC
• Lakewood Dental Studio PLLC (Lakewood Dental Studio)

• Durable Medical Equipment & Medical Supplies in Dallas, TX
• Providers in Dallas, TX by specialty
• Durable Medical Equipment & Medical Supplies in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.