NPI: 1376577023 · LAKEPORT, CA 95453 · Community/Retail Pharmacy · NPI assigned 07/10/2006
| Authorized Official | NEELEY, ROBERT (OWNER) |
| NPI Enumeration Date | 07/10/2006 |
| Year | Claims | Total Paid |
|---|---|---|
| 2021 | 54 | $136.54 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| A9999 | Miscellaneous dme supply or accessory, not otherwise specified | 54 | 41 | $136.54 |