# LAKE HEALTH SERVICES, INC.

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** LAKE HEALTH SERVICES, INC.
- **Other names:** Lake Pharmacy
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1043071962
- **Legal business name:** LAKE HEALTH SERVICES, INC.
- **Authorized official:** TIM NGUYEN PHARMD (PRESIDENT)
- **Authorized official phone:** (707) 994-3141

## Contact information

- **Practice address:** 15230 LAKESHORE DR, CLEARLAKE, CA 95422-8107
- **Practice address phone:** (707) 994-3141
- **Practice address fax:** (707) 994-7150
- **Mailing address:** PO BOX 7150, CLEARLAKE, CA 95422-7150
- **Mailing address phone:** (707) 994-3141

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 01/18/2024
- **Last updated:** 02/04/2024