Lakeside Orthopedic Institute LLC
Durable Medical Equipment & Medical Supplies in Lake Havasu City, AZ. Organization (NPI-2).
Details
- NPI
- 1750124368
- Entity type
- Organization (NPI-2)
- Legal business name
- Lakeside Orthopedic Institute LLC
- Organization subpart
- No
- Enumeration date
- Jun 13, 2024
- Certification date
- Apr 22, 2026
- Last updated
- Apr 22, 2026
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 332B00000X | Durable Medical Equipment & Medical Supplies | – | – | Yes |
Practice location
25 Riviera BlvdLake Havasu City, AZ 86403-5694
Phone 928-505-5555
Mailing address
25 Riviera BlvdLake Havasu City, AZ 86403-5694
Phone 928-505-5555
Authorized official
Daniel Edward Heiner
Ao
9285055555
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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