| NPI | 1760617211 |
|---|---|
| Doing Business As | LAKESIDE DURABLE MEDICAL EQUIPMENT |
| Entity Type | Organization |
| Authorized Contact | CORTNIE RENEE WELLMAN Owner 936-828-1919 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies |
| Enumeration Date | 2009-05-27 |
| Last Update Date | 2009-10-14 |