LAKE REGIONAL HEALTH SYSTEM NPI 1417492091

NPI Information

NPI: 1417492091
Provider Name: LAKE REGIONAL HEALTH SYSTEM

Doing Business As: LAKE REGIONAL HOSPICE

Classification: Hospice Care, Community Based - 251G00000X
Entity Type: Organization
Address:
1029 NICHOLS RD STE A
OSAGE BEACH, MO
ZIP 65065
Phone: (573) 302-2860
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LAKE REGIONAL HEALTH SYSTEM is a hospice care community based in Osage Beach, MO. LAKE REGIONAL HEALTH SYSTEM NPI is 1417492091. The provider is registered as an organization entity type.
The provider Is Doing Business As Lake Regional Hospice.

The provider's business location address is:

1029 NICHOLS RD STE A
OSAGE BEACH, MO
ZIP 65065-702
Phone: (573) 302-2860

The provider's authorized official is Kevin Mcroberts .
The authorized official title is Ceo and has the following contact phone number (573) 348-8756.

The enumeration date for this NPI number is 1/5/2017 and was last updated on 10/12/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	315D00000X	Hospice, Inpatient				No
2	251G00000X	Hospice Care, Community Based				Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	820052478	MEDICAID	MISSOURI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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