Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1265263701 Individual Practitioner Male Practitioner

Dr. Connor Trenton Lake , PharmD

Pharmacist • Hannibal, MO

Professional Overview & Biography Verified Profile Summary

Dr. Connor Lake, PharmD is a registered healthcare professional specializing in Pharmacist in Hannibal, MO. Practice services are available at 3650 STARDUST DR under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

3650 Stardust Dr

Hannibal, MO 634012411

Telephone 5734060682
Associated Practice Facility / Clinic
🏢 Wal-Mart Stores East Lp Facility NPI 1407873730

Specialty Benchmarks & Practice Insights

Comparative analytics for Pharmacist in Hannibal, MO

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 10.7 Yrs
Regional Practice Density
20 Specialists

Practicing in Hannibal, MO (5469 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2025-01-22
Pharmacist Primary Specialty

NUCC Taxonomy Code: 183500000X

State License MO 2024031293

An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care.

Pharmacist

NUCC Taxonomy Code: 183500000X

State License IL 051306670

An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

7 Associated Practitioners
Judy Wilcox

Pharmacist

NPI 1043811367
Laurie Hjelm

Pharmacist

NPI 1306447230
NPI 1336860964

Doctor of Pharmacy (Pharm.D.)

Julie Hamilton

Pharmacist

NPI 1588265797
NPI 1700479524

Doctor of Pharmacy (Pharm.D.)

NPI 1881295129

Doctor of Pharmacy (Pharm.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) January 22, 2025

Pharmacist (License #051306670 in IL)

NPI Profile Active August 07, 2024

NPI status registered as active in NPPES database

📍
Updated Practice Location August 07, 2024

Registered at 3650 STARDUST DR, HANNIBAL, MO 634012411 (Tel: 5734060682)

📍
Updated Business Mailing Address August 07, 2024

Registered at 3650 STARDUST DR, HANNIBAL, MO 634012411 (Tel: 5734060682)

👤
Provider Name / Credentials Updated August 07, 2024

Recorded as CONNOR LAKE, PHARMD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) August 07, 2024

Pharmacist (License #2024031293 in MO)

🟢
Initial NPI Registration & Enumeration August 07, 2024

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1265263701
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 07, 2024
Last Update: January 22, 2025
Sole Proprietor: No

Mailing Address

3650 Stardust Dr

Hannibal, MO 634012411

Phone: 5734060682

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.