LAKELAND HOME PROGRAM LLC (NPI# 1396267878) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396267878 |
| Entity Type | Organization |
| Organization Name | LAKELAND HOME PROGRAM LLC |
| Other Organization Name | FRESENIUS MEDICAL CARE - WEST HINDS COUNTY |
| Practice Address |
105 Johnston Pl Clinton MS 39056-5911 |
| Practice Telephone | 6019259296 |
| Enumeration Date | 2017-07-17 |
| Last Update Date | 2017-07-17 |
| Authorized Official Name | MARK FAWCETT (SENIOR VICE PRESIDENT & TREASURER) |
| Authorized Official Telephone | 7816999000 |
| Is Organization Subpart | Y |
| Parent Organization Name | FRESENIUS MEDICAL CARE HOLDINGS, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QE0700X |
Clinic/Center Specialization: End-Stage Renal Disease (ESRD) Treatment |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Fresenius Medical Care - West Hinds County | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184146789 | Lakeland Home Program LLC | Clinic/Center | 209 Mar Lyn Dr, Brandon, MS 39042 | 2017-07-14 |
| 1497193023 | Lakeland Home Program LLC | Clinic/Center | 1010 Lakeland Square Ext Ste A, Flowood, MS 39232-7607 | 2013-06-05 |
| Street Address |
105 JOHNSTON PL |
| City | CLINTON |
| State | MS |
| Zip Code | 39056-5911 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770036469 | Bio-medical Applications of Mississippi, Inc. | Clinic/Center | 105 Johnston Pl, Clinton, MS 39056-5911 | 2016-07-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376012724 | John Melvin Goolsby Jr. | Dentist | 457 Highway 80 East, Clinton, MS 39056 | 2018-11-15 |
| 1225534530 | Magnolia Allergy Clinic LLC | Internal Medicine | 402 Cynthia St Ste E, Clinton, MS 39056 | 2018-04-04 |
| 1578093704 | Melinda A Weisenberger | Specialist/Technologist | 4600 W Northside Drive, Clinton, MS 39056 | 2017-06-20 |
| 1962859702 | Telehealthone, LLC | Nurse Practitioner | 200 Clinton Plaza, Clinton, MS 39056 | 2016-05-23 |
| 1841686581 | 1st America Infusion Services LLC | Durable Medical Equipment & Medical Supplies | 132 Fairmont Street, Suite B, Clinton, MS 39056 | 2015-04-09 |
| 1023412822 | Rebecca Brooks Prewitt | Social Worker | 130 B Fairmont Street, Clinton, MS 39056 | 2014-10-22 |
| 1396184149 | Robert Joseph Hargis | Urology | 116 Afton Way, Clinton, MS 39056 | 2013-06-14 |
| 1750626321 | Clinton Dental Care, Inc. | Dentist | 736 Clinton Pkwy, Clinton, MS 39056 | 2012-12-07 |
| 1922394469 | Daphenia C. Knight Starling | Nurse Practitioner | Clinton Healthcare, 1251 Pinehaven Rd, Clinton, MS 39056 | 2011-06-23 |
| 1134443385 | Gwendolyn Coleman Garror | Pharmacist | 132 Fairmount Drive, Clinton, MS 39056 | 2010-03-17 |
| Find all providers in zip 39056 | ||||
| Taxonomy Code | 261QE0700X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | End-Stage Renal Disease (ESRD) Treatment |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770036469 | Bio-medical Applications of Mississippi, Inc. | Clinic/Center | 105 Johnston Pl, Clinton, MS 39056-5911 | 2016-07-28 |
| 1962860288 | Total Renal Care Inc | Clinic/Center | 331 North Blvd, Clinton, NC 28328-1911 | 2016-02-01 |
| 1053705483 | Clinton Dialysis Clinic LLC | Clinic/Center | 103 Ab Jacks Rd, Clinton, SC 29325-2112 | 2015-03-24 |
| 1013344811 | Fresenius Medical Care Surrats, LLC | Clinic/Center | 8949 Woodyard Rd., Clinton, MD 20735-4203 | 2013-10-11 |
| 1548697402 | Colleton Dialysis LLC | Clinic/Center | 604 Kansas Ave, Clinton, MO 64735-3069 | 2013-10-08 |
| 1760765036 | Bio-medical Applications of Maryland Inc. | Clinic/Center | 8949 Woodyard Road, Clinton, MD 20735-4203 | 2011-09-23 |
| 1588890024 | Rai Care Centers of Clinton LLC | Clinic/Center | 7201 Old Alexandria Ferry Road, Clinton, MD 20735-1865 | 2009-06-10 |
| 1093827800 | Bio-medical Applications of Clinton, Inc. | Clinic/Center | 1740 Southeast Blvd, Clinton, NC 28328-4738 | 2006-08-31 |
| 1093827818 | Rcg University Division, Inc. | Clinic/Center | 317 Professional Park Rd, Clinton, SC 29325-7625 | 2006-08-31 |
| 1770502916 | Dialysis Clinic Inc. | Clinic/Center | 1662 N 2nd St, Clinton, MO 64735-1141 | 2006-07-19 |
| Find all providers in CLINTON | ||||
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| 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.