| Lake Regional Health System | |
|
156 Missouri Boulevard Suite B Laurie MO 65038-4933 | |
| (573) 374-5263 | |
| (573) 374-4933 |
| Full Name | Lake Regional Health System |
|---|---|
| Speciality | Clinic/Center |
| Location | 156 Missouri Boulevard, Laurie, Missouri |
| Authorized Official Name and Position | Kevin Mcroberts (CEO) |
| Authorized Official Contact | 5733488756 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake Regional Health System Po Box 801661 Kansas City MO 64180-1661 Ph: (573) 348-8000 | Lake Regional Health System 156 Missouri Boulevard Suite B Laurie MO 65038-4933 Ph: (573) 374-5263 |
| NPI Number | 1427162254 |
|---|---|
| Provider Enumeration Date | 08/18/2006 |
| Last Update Date | 10/13/2023 |
| Medicare PECOS PAC ID | 9133026776 |
|---|---|
| Medicare Enrollment ID | O20140428000494 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427162254 | NPI | - | NPPES |
| 594949901 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |