Lakeside Pharmacy

LBN: Hyperion Llc
Lakeside Pharmacy is an health care organization with primary practice located at 605 N Main St , Eufaula OK 74432-1634. The organization recently has 4 registered licenses in different health care specialties including Suppliers / Community/Retail Pharmacy, Suppliers / Compounding Pharmacy, Suppliers / Long Term Care Pharmacy, Suppliers / Specialty Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Hyperion Llc can be contacted via phone (918) 689-9940, or through Tidwell, Darren via phone (918) 689-9940.

Contact Information

Primary practice address
605 N Main St Eufaula OK 74432-1634
Phone: (918) 689-9940
Fax: (918) 689-7557
Website:
Map and Directions
Authorized official contact:
Name: Tidwell, Darren
Phone: (918) 689-9940

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Community/Retail Pharmacy 3336C0003X 48-5526 Oklahoma
Suppliers / Compounding Pharmacy 3336C0004X
Suppliers / Long Term Care Pharmacy 3336L0003X
Suppliers / Specialty Pharmacy 3336S0011X

Profile Details

NPI number 1295867612
LBN Legal business name Hyperion Llc
DBA Doing business as Lakeside Pharmacy
Authorized official Tidwell, Darren
Entity Organization
Organization subpart 1 No
Enumeration date Mar 12th, 2007
Last updated May 27th, 2015 - about 11 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1295867612 NPPES
Oklahoma MEDICAID 200287060A
Oklahoma Other 2125414

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