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SCH260186-06 Lake Regional Health System (Active)
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Main Details
Name
Lake Regional Health System
Subdivision Name
Lake Regional Clinic-Camdenton
Type
Sole Community Hospital
Rural
Yes
340B ID
SCH260186-06
Medicare Provider Number
260186
Outpatient Facility Provider Number
268707
Additional Details
Current Program Status
Active
Registration Date
10/4/2016
Participating Start Date
1/1/2017
Participating Approval Date
12/15/2016
Last Recertification Date
8/13/2024
Contacts
Authorizing Official
Lake Regional Health System
Paula Littleton, CFO
(573) 348-8388
Primary Contact
Lake Regional Health System
Tony Kauten, Pharmacy Manager
(573) 348-8763
Addresses
Street Address
1930-A N BUSINESS ROUTE 5
CAMDENTON WINDSOR ESTATES
CAMDENTON, MO 65020
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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