LAKESIDE PHARMACY
NPI 1215079595
Durable Medical Equipment & Medical Supplies in Eufaula, OK
NPI Status: Active since February 13, 2007
Contact Information
605 N MAIN ST
EUFAULA, OK
ZIP 74432
Phone: (918) 689-9940
Fax: (918) 689-7557
- Organization
- Durable Medical Equipment & Medical Supp...
- Medicare Supplier
- Does Not Accept Medicare Approved Payment
- CLIA Number: 37D2250485
- CLIA Cert. Type: Pharmacy
- CLIA Exp. Date: 01-26-2028
About LAKESIDE PHARMACY
This page provides the complete NPI Profile along with additional information for Lakeside Pharmacy, a provider established in Eufaula, Oklahoma operating as a Durable Medical Equipment & Medical Supplies. The healthcare provider is registered in the NPI registry with number 1215079595 assigned on February 2007. The practitioner's primary taxonomy code is 332B00000X. The provider is registered as an organization and their NPI record was last updated 6 years ago. The provider's is doing business as Lakeside Pharmacy. The authorized official of this NPI record is Larry Hoffman (President)
- NPI
- 1215079595
- Provider Legal Name
- BENT WILLOW INC
- Other Organization Name
- LAKESIDE PHARMACY
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 605 N MAIN ST EUFAULA, OK 74432
- Location Phone
- (918) 689-9940
- Location Fax
- (918) 689-7557
- Mailing Address
- 605 N MAIN ST EUFAULA, OK 74432
- Mailing Phone
- (918) 689-9940
- Mailing Fax
- (918) 689-7557
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 02-13-2007
- Last Update Date
- 08-22-2020
- Code Navigator
Lakeside Pharmacy is a medicare supplier with PTAN 20529287 who does not accept Medicare assignment for all durable medical equipment and supplies. The provider may not accept the Medicare allowable as payment in full and may collect additional payment directly from the patient, and/or charge more than the Medicare allowable.The supplier carries the following product categories: Epoetin or Immunosuppressive Drugs or Infusion Drugs or Nebulizer Drugs or Oral Anticancer Drugs or Oral Antiemetic Drugs or Commodes, Urinals, Bedpans or Blood Glucose Monitors/Supplies (Non-Mail Order) or Heat & Cold Applications or Hospital Beds (Electric) or Hospital Beds (Manual) or Insulin Infusion Pumps and/or Supplies or Implanted Infusion Pumps and/or Supplies or Support Surfaces: Pressure Reducing Beds/Mats/Pads or Traction Equipment or (TENS) Transcutaneous Electrical Nerve Stimulators and/or Supplies or Canes and/or Crutches or Patient Lifts or Power Operated Vehicles (Scooters) or Seat Lift Mechanisms or Walkers or Wheelchairs (Standard Manual) or Wheelchairs (Standard Manual Related Accessories) or Wheelchairs (Standard Power) or Wheelchairs (Standard Power Related Accessories) or Wheelchair Seating/Cushions or Orthoses: Off-The-Shelf or Penile Pumps or Ostomy Supplies or Tracheotomy Supplies or Enteral Nutrients or Enteral Equipment and/or Supplies or Nebulizer Equipment and/or Supplies or Oxygen Equipment and/or Supplies or Respiratory Assist Devices or Ventilators Accessories and/or Supplies or Surgical Dressings or Diabetic Shoes and Inserts or Diabetic Shoes/Inserts - Custom.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Durable Medical Equipment & Medical Supplies
- Taxonomy Code
- 332B00000X
- Type
- Suppliers
- Taxonomy Description
- 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.
Medical Equipment Supplier
The provider carries the following medical supplies product categories:
- PTAN
- 20529287
- Accepts Medicare Assignment
- NO
- Specialities List
- Pharmacy.
- Provider Type List
- OXYGEN & EQUIPMENT.
- Competitive Bidding
- NO
Supplies List
- Epoetin - Epoetin is a man-made version of human erythropoietin (EPO)
- Immunosuppressive Drugs - Immunosuppressive drugs require dosage, frequency, and route of administration to prevent or treat the rejection of an organ transplant
- Infusion Drugs -
- Nebulizer Drugs - Albuterol, levalbuterol, and metaproterenol are all short-acting bronchodilators with beta-adrenergic stimulatory effect
- Oral Anticancer Drugs - FDA anticancer drugs
- Oral Antiemetic Drugs - FDA antiemetic drugs
- Commodes, Urinals, Bedpans - Raised toilets, Drop-arm commodes, Folding commodes, Plastic urinals, Plastic bedpans, Disposable urinals
- Blood Glucose Monitors/Supplies (Non-Mail Order) - Home blood glucose monitors including lancets, reagent strips, and other supplies necessary for the proper functioning of the device
- Heat & Cold Applications - Heat therapy, Cold therapy, Heating pads
- Hospital Beds (Electric) - Total electric hospital beds, Semi-electric hospital beds
- Hospital Beds (Manual) - Fixed height hospital beds, Variable height hospital beds
- Insulin Infusion Pumps and/or Supplies - Disposable Insulin Delivery System, Mechanical insulin infusion pumps, Needle type infusion sets, Cannula type infusion sets
- Implanted Infusion Pumps and/or Supplies - Implantable infusion pumps, catheters, refill kits
- Support Surfaces: Pressure Reducing Beds/Mats/Pads - Group 1 – Alternating pressure pad, Air/Water/Dry pressure pad or pressure mattress. Group 2 - Pressure reducing powered air mattresses, Powered air flotation bed, non-powered pressure reducing mattress Group 3 – Air fluidized bed
- Traction Equipment - Traction tables, Traction machines, Inversion tables
- (TENS) Transcutaneous Electrical Nerve Stimulators and/or Supplies - Transcutaneous Electrical Nerve Stimulation (TENS) for the relief of acute post-operative pain
- Canes and/or Crutches - Standard Canes, Quad Canes, Offset Canes, Standard Crutches, Forearm Crutches
- Patient Lifts - Ceiling lifts, Slings
- Power Operated Vehicles (Scooters) - Scooters
- Seat Lift Mechanisms - Lift chair
- Walkers - Standard Walkers, Wheeled Walkers, Folding Walker
- Wheelchairs (Standard Manual) - Standard wheelchairs, transport wheelchairs, heavy duty wheelchairs
- Wheelchairs (Standard Manual Related Accessories) - Accessories for standard wheelchairs, transport wheelchairs, heavy duty wheelchairs
- Wheelchairs (Standard Power) - Standard power wheelchairs, Heavy duty standard power wheelchairs
- Wheelchairs (Standard Power Related Accessories) - Accessories for standard power wheelchairs, heavy duty standard power wheelchairs
- Wheelchair Seating/Cushions - Wheelchair seat cushions, Wheelchair bank cushions, Wheelchair padded armrests
- Orthoses: Off-The-Shelf - Met pads, Heel pads, Heel spur pads
- Penile Pumps -
- Ostomy Supplies - Pouches, Paste, Powder, Barrier wipes
- Tracheotomy Supplies - Tracheostomy care kits
- Enteral Nutrients - Enteral formula
- Enteral Equipment and/or Supplies - Enteral infusion pumps, enteral nutrition supply kits
- Nebulizer Equipment and/or Supplies - Nebulizers, Atomizers, Filters
- Oxygen Equipment and/or Supplies - Portable oxygen systems, Oxygen concentrators, Oxygen contents
- Respiratory Assist Devices -
- Ventilators Accessories and/or Supplies - Volume control ventilator, Pressure support ventilator
- Surgical Dressings - Gauze, Elastic bandages, Adhesive tape
- Diabetic Shoes and Inserts - Shoes, Socks, Insoles
- Diabetic Shoes/Inserts - Custom - Custom fabricated shoes, socks, & insoles
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 37D2250485
- Facility Type
- Pharmacy
- Certificate Effective Date
- January 27, 2026
- Certificate Expiration Date
- January 26, 2028
- Laboratory Director
- JAMES A. DIXON
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Lakeside Pharmacy to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1215079595, we treat the final digit (5) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 65. The final step is to find the difference between that total and the next multiple of ten (70 - 65 = 5).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 65 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 3 providers are registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1215079595, enumerated as an "organization" on February 13, 2007.
The provider is located at 605 N MAIN ST EUFAULA, OK 74432 and the phone number is (918) 689-9940.
Durable Medical Equipment & Medical Supplies with taxonomy code 332B00000X.
