Organization
LAKE REGIONAL HEALTH SYSTEM
Active
Other names
Lake Regional Clinic-Lebanon
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN MCROBERTS (CEO)
(573) 348-8388
Entity
Organization
Contact information
Practice address
755 COWAN DRIVE, LEBANON, MO 65536
(417) 532-2805
(417) 532-2848
Mailing address
PO BOX 801661, KANSAS CITY, MO 64180-1661
(573) 348-8000
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
590107490
—
MO
Enumeration date
08/27/2021
Last updated
10/12/2023
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