| NPI | 1316933658 |
|---|---|
| Doing Business As | LAKESIDE DME |
| Entity Type | Organization |
| Authorized Contact | A BRANDON ADAMS President 501-548-0190 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: AR 005155) |
| Enumeration Date | 2005-09-22 |
| Last Update Date | 2007-12-03 |