MOUNTAIN LAKES MEDICAL SUPPLY INC NPI 1639250046

NPI Information

NPI: 1639250046
Provider Name: MOUNTAIN LAKES MEDICAL SUPPLY INC
Classification: Durable Medical Equipment & Medical Supplies - 332B00000X
Entity Type: Organization
Address:
226 E. FAIRWAY BLVD
BIG BEAR CITY, CA
ZIP 92314
Phone: (909) 585-1339
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MOUNTAIN LAKES MEDICAL SUPPLY INC is a durable medical equipment medical supplies in Big Bear City, CA. The provider is a supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time. MOUNTAIN LAKES MEDICAL SUPPLY INC NPI is 1639250046. The provider is registered as an organization entity type.

The provider's business location address is:

226 E. FAIRWAY BLVD
BIG BEAR CITY, CA
ZIP 92314-050
Phone: (909) 585-1339
Fax: (909) 585-3646

The provider's authorized official is Marc K Lapham .
The authorized official title is Owner Operator and has the following contact phone number (909) 585-1339.

The enumeration date for this NPI number is 10/18/2006 and was last updated on 7/18/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	332B00000X	Durable Medical Equipment & Medical Supplies		102727	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	D08601548	OTHER	CALIFORNIA	SUBMITTER ID
2	DME01937F	MEDICAID	CALIFORNIA
3	4129290001	MEDICARE NSC	CALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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