Organization
LAKE REGIONAL HEALTH SYSTEM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL E. HENZE (CHIEF EXECUTIVE OFFICER)
(573) 348-8392
Entity
Organization
Contact information
Practice address
54 HOSPITAL DR, OSAGE BEACH, MO 65065-3050
(573) 348-8000
Mailing address
54 HOSPITAL DR, OSAGE BEACH, MO 65065-3050
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
291-35
MO
Other
Enumeration date
02/21/2013
Last updated
02/21/2013
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