Organization
LAKES AREA PHARMACY
Active
Other names
Dura Med, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
CRESTA H TATE (CONTROLLER)
(512) 756-8550
Entity
Organization
Contact information
Practice address
608 BUCHANAN DR, BURNET, TX 78611-2306
(512) 756-8550
Mailing address
608 BUCHANAN DR, BURNET, TX 78611-2306
(512) 756-8550
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
0068661
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
014179801
—
TX
01
—
282501
SCOTT AND WHITE
—
Enumeration date
07/16/2008
Last updated
07/16/2008
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