| Organization Name: | LAKESIDE HOME MEDICAL EQUIPMENT INC |
| NPI Number: | 1477862241 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SHELLA ANN HARRIS (PRESIDENT) |
| Mailing Address: | 2418 S Highway 76 Russell Springs |
| State: | KY US |
| Postal Code: | 426428845 |
| Phone Number: | 2708662271 |
| Fax Number: | |
| NPI Enumeration Date: | 09/28/2010 |
| NPI Last Update Date: | 09/28/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332BX2000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | KY |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | Oxygen Equipment & Supplies |
| Taxonomy Definition: | |