Organization
LAKE RESPIRATORY SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ALBERT MAIR (OWNER)
(365) 589-5777
Entity
Organization
Contact information
Practice address
1321 S BAY ST, EUSTIS, FL 32726-5550
(365) 589-5777
(365) 589-4355
Mailing address
1321 S BAY ST, EUSTIS, FL 32726-5550
(365) 589-5777
(365) 589-4355
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
853
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
022293300
—
FL
Enumeration date
02/23/2006
Last updated
07/02/2010
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