Organization
LAKE REGIONAL HEALTH SYSTEM
Active
Other names
Lake Regional Pharmacy - Eldon
Organization subpart
No
Provider details
NPI number
Authorized official
PAULA SUE LITTLETON (CFO)
(573) 348-8388
Entity
Organization
Contact information
Practice address
416B S MAPLE ST, ELDON, MO 65026-1812
(573) 557-2231
(573) 392-5808
Mailing address
PO BOX 1560, OSAGE BEACH, MO 65065-1560
(573) 302-3185
(573) 302-3464
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
2017025596
MO
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2168691
PK
—
05
—
600045506
—
MO
Enumeration date
03/30/2017
Last updated
01/07/2025
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