Lakeside Healthcare Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

LAKESIDE HEALTHCARE INC

Practice address

203 Amicks Ferry Rd
Suite 1000
Chapin, SC 29036-8663

Phone

(803) 932-7080

Fax

(803) 932-0879

NPI assigned

Nov 21, 2005

Last updated

Aug 22, 2020By 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

Mr. Mi Chael W Houmiel

Title

Vice President

Phone

(803) 932-7080

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1132531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1922081215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 AMICKS FERRY RD",
            "address_2": "SUITE 1000",
            "city": "CHAPIN",
            "state": "SC",
            "postal_code": "290368663",
            "telephone_number": "803-932-7080",
            "fax_number": "803-932-0879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 AMICKS FERRY RD",
            "address_2": "SUITE 1000",
            "city": "CHAPIN",
            "state": "SC",
            "postal_code": "290368663",
            "telephone_number": "803-932-7080",
            "fax_number": "803-932-0879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESIDE HEALTHCARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HOUMIEL",
        "authorized_official_first_name": "MI CHAEL",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "803-932-7080",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "SC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DE1423",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Chapin, SC
• Providers in Chapin, SC by specialty
• Durable Medical Equipment & Medical Supplies in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.