LAKELINE MEDICAL SUPPLY (NPI# 1043482540) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043482540 |
| Entity Type | Organization |
| Organization Name | LAKELINE MEDICAL SUPPLY |
| Practice Address |
1525 Cypress Creek Rd Ste H Cedar Park TX 78613-3604 |
| Practice Telephone | 5126335669 |
| Practice Fax Number | 5124012145 |
| Mailing Telephone | 5126335669 |
| Mailing Fax Number | 5124012145 |
| Enumeration Date | 2008-03-25 |
| Last Update Date | 2008-03-25 |
| Authorized Official Name | TYSON JON KRUGMAN (OWNER) |
| Authorized Official Telephone | 5126335669 |
| Authorized Official Credential | DC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | 0103078 | TX | Suppliers |
| Street Address |
1525 CYPRESS CREEK RD STE H |
| City | CEDAR PARK |
| State | TX |
| Zip Code | 78613-3604 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841891280 | Honor Audiology, LLC | Audiologist | 1807 Cypress Creek, Ste 106, Ceder Park, TX 78613 | 2020-11-03 |
| 1750980801 | Sheneil Roberts | Pharmacist | 101 Commercial Pkwy, Cedar Park, TX 78613 | 2020-10-20 |
| 1821606674 | Whitney Olivia White | Dentist | 4807 183a, Ste 100, Cedar Park, TX 78613 | 2020-07-17 |
| 1427681436 | Alex Parnell | Marriage & Family Therapist | 3000 Polar Lane, 602, Cedar Park, TX 78613 | 2020-02-18 |
| 1497216642 | Rolling Hills Healthcare, Inc. | Hospice Care, Community Based | 1101 Arrow Point Dr Ste 301, Cedar Park, TX 78613 | 2019-03-29 |
| 1265907828 | Mary Kathleen Williams | Clinical Nurse Specialist | 1103 Pagedale Drive, Cedar Park, TX 78613 | 2018-10-10 |
| 1982187514 | Elizabeth Harwell | Physical Therapy Assistant | 1500 Cottonwood Creek Trail, Cedar Park, TX 78613 | 2018-09-10 |
| 1346722246 | Riddhi Gohel | Optometrist | 11200 Lakeline Mall Dr Ste H5, Cedar Park, TX 78613 | 2018-09-06 |
| 1528546736 | Lakeline Emergency Center, LLC | Clinic/Center | 1860 S. Lakeline Blvd, Cedar Park, TX 78613 | 2018-07-31 |
| 1710464458 | Kelsey Alyse Hayes | Dietitian, Registered | 1401 Medical Pkwy B, Suite 101, Cedar Park, TX 78613 | 2018-07-25 |
| Find all providers in zip 78613 | ||||
| Taxonomy Code | 332B00000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| 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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245698406 | Hanger Prosthetics & Orthotics West, Inc. | Durable Medical Equipment & Medical Supplies | 1301 Medical Pkwy Ste 120, Cedar Park, TX 78613-2529 | 2016-02-03 |
| 1588038368 | Central Texas Pain Institute Pllc | Durable Medical Equipment & Medical Supplies | 1401 Medical Pkwy Ste 345, Cedar Park, TX 78613-7763 | 2015-11-17 |
| 1033535992 | Wal-mart Stores Texas Lp | Durable Medical Equipment & Medical Supplies | 2801 E Whitestone Blvd, Cedar Park, TX 78613-7273 | 2014-03-14 |
| 1265798490 | Dowden Managment Co., LLC | Durable Medical Equipment & Medical Supplies | 715 Discovery Blvd Ste 504, Cedar Park, TX 78613-2417 | 2012-04-02 |
| 1588858625 | Cvs Pharmacy Inc. | Durable Medical Equipment & Medical Supplies | 1101 C-bar Ranch Trl Lot 2, Cedar Park, TX 78613-7595 | 2007-08-31 |
| 1962694984 | Cvs Pharmacy, Inc. | Durable Medical Equipment & Medical Supplies | 1950 Bagdad Rd, Cedar Park, TX 78613-6425 | 2007-08-14 |
| 1912058850 | Pulmonary Innovation Specialists | Durable Medical Equipment & Medical Supplies | 601 S Bell Blvd, Ste B, Cedar Park, TX 78613-3854 | 2007-01-16 |
| 1447334289 | P&h Services, LLC | Durable Medical Equipment & Medical Supplies | 11901 W Parmer Lane, Suite 210, Cedar Park, TX 78613-7653 | 2006-10-25 |
| 1821005703 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 1495 Cypress Creek Rd, Cedar Park, TX 78613-3602 | 2006-08-02 |
| 1205853348 | Wal-mart Stores Texas LLC | Durable Medical Equipment & Medical Supplies | 201 Walton Way, Cedar Park, TX 78613-7016 | 2006-07-16 |
| Find all providers in CEDAR PARK | ||||
| City | CEDAR PARK |
| Zip Code | 78613 |
Please comment or provide details below to improve the information on LAKELINE MEDICAL SUPPLY.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.