Lakes Area Pharmacy
Organization Active NPI Durable Medical Equipment & Medical Supplies · Burnet, TX
NPI 1891959003 · NPPES record last updated Jul 16, 2008
Key facts
- NPI
- 1891959003
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Durable Medical Equipment & Medical Supplies 332B00000X
- License
- 0068661 (TX)
- Legal business name
- LAKES AREA PHARMACY
- Practice address
- 608 Buchanan Dr
Burnet, TX 78611-2306 - Phone
- (512) 756-8550
- NPI assigned
- Jul 16, 2008
- Organization subpart
- No
Authorized official
- Name
- Cresta H Tate
- Title
- Controller
- Phone
- (512) 756-8550
Other NPIs on the same Medicare enrollment 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100930040662 | TX | DME Supplier - Medical Supply Company |
4385605666 |
1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Llano, TX |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | 0068661 | TX | Yes |
Addresses
Primary practice location
608 Buchanan Dr
Burnet, TX 78611-2306
Mailing address
608 Buchanan Dr
Burnet, TX 78611-2306
Phone (512) 756-8550
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 014179801 | Medicaid | TX | |
| 282501 | Other | SCOTT AND WHITE |
Other names
- Dura Med, Inc.
Other providers in Burnet, TX
- Chandra E Irvin
- Jeremy L Danson OD PA
- Meredith Jowers
- Kenneth Lester Malamud MD PLLC
- Kickstart Kids Therapy, PLLC
- Joseph Jeffrey Lamb
- David Tao-Way Lim
- David L. Lindzey
- John Baptiste Litterer
- Lone Star ABA Services LLC
All providers in Burnet, TX · Durable Medical Equipment & Medical Supplies in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 16, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.