LAKESIDE PHARMACY (NPI# 1063527018) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063527018 |
| Entity Type | Organization |
| Organization Name | LAKESIDE PHARMACY |
| Practice Address |
31681 Riverside Dr Ste D Lake Elsinore CA 92530-7815 |
| Practice Telephone | 9512457699 |
| Practice Fax Number | 9512457721 |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2008-07-08 |
| Authorized Official Name | SHARON HUTTON (OWNER) |
| Authorized Official Telephone | 9512457699 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
PHY47386 | CA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OTHER ID NUMBER-COMMERCIAL NUMBER | 5623283 | 01 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | LAKESIDE PHARMACY LLC | 233 E 2nd St, Tonasket, WA 98855-9294 |
| Street Address |
31681 RIVERSIDE DR STE D |
| City | LAKE ELSINORE |
| State | CA |
| Zip Code | 92530-7815 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538437934 | Lisa Renee Washington | Counselor | 31681 Riverside Dr, Suite L, Lake Elsinore, CA 92530-7815 | 2011-12-13 |
| 1225342579 | Ivan Negrete | Counselor | 31681 Riverside Dr, Suite L, Lake Elsinore, CA 92530-7815 | 2010-07-28 |
| 1780910786 | Timothy M Olson | Marriage & Family Therapist | 31681 Riverside Dr, Suite L, Lake Elsinore, CA 92530-7815 | 2009-10-26 |
| 1134452899 | Yerina Hernandez | Marriage & Family Therapist | 31681 Riverside Dr, Suite L, Lake Elsinore, CA 92530-7815 | 2009-09-14 |
| 1881927788 | Judith Guijarro | Counselor | 31681 Riverside Dr, Suite L, Lake Elsinore, CA 92530-7815 | 2009-09-09 |
| 1982937884 | Julie Koo | Social Worker | 31681 Riverside Dr, Suite L, Lake Elsinore, CA 92530-7815 | 2009-09-09 |
| 1588899876 | Cory Leroy | Counselor | 31681 Riverside Dr, Suite L, Lake Elsinore, CA 92530-7815 | 2009-05-15 |
| 1811130941 | Myrna Veronica Casillas-harris | Counselor | 31681 Riverside Dr, Suite L, Lake Elsinore, CA 92530-7815 | 2009-04-20 |
| 1083854806 | Shannon Elizabeth Pulsifer | Marriage & Family Therapist | 31681 Riverside Dr, Suite L, Lake Elsinore, CA 92530-7815 | 2009-03-06 |
| 1225274053 | Lissett Torress | Counselor | 31681 Riverside Dr, Suite L, Lake Elsinore, CA 92530-7815 | 2008-12-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841801479 | Mercedes Samantha Hamilton | Licensed Psychiatric Technician | 18465 Grand Ave, Lake Elsinore, CA 92530 | 2020-08-17 |
| 1700423779 | Karrene Louise Stanard | Peer Specialist | 31764 Casino Drive, Suite 300, Lake Elsinore, CA 92530 | 2019-12-09 |
| 1972149961 | Danielle Cravalho | Student in an Organized Health Care Education/Training Program | 31964 Mission Trail, Suite B, Lake Elsinore, CA 92530 | 2019-11-25 |
| 1952825648 | R.e. Levi Dental Corporation | Dentist | 32235 Mission Trail # 8, Lake Elsinore, CA 92530 | 2017-08-03 |
| 1144760729 | Alfred Metwashla | Pharmacist | 18269 Collier Ave, Lake Elsinore, CA 92530 | 2017-03-02 |
| 1750788733 | Roxanne Martinez | Case Manager/Care Coordinator | 31764 Casino Drive, Lake Elsinore, CA 92530 | 2014-11-19 |
| 1871870907 | Bryan Tuan Tran | Pharmacist | 160 Diamond Drive, Lake Elsinore, CA 92530 | 2011-11-03 |
| 1043590821 | Katherynn Elizabeth Williams | Marriage & Family Therapist | 600 Central Ave Ste 201, Lake Elsinore, CA 92530 | 2011-08-24 |
| 1861771677 | Judy Kelly | Marriage & Family Therapist | 224 West Graham Ave, Lake Elsinore, CA 92530 | 2011-08-10 |
| 1427343813 | Patrick Chern | Pharmacist | 18287 Collier Ave., Lake Elsinore, CA 92530 | 2011-06-14 |
| Find all providers in zip 92530 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700036290 | Van Lou Investments | Pharmacy | 31571 Canyon Estates Dr. #118, Lake Elsinore, CA 92530 | 2008-09-22 |
| 1811070444 | Garfield Beach Cvs LLC | Pharmacy | 18287 Collier Ave, Lake Elsinore, CA 92530-2755 | 2006-10-24 |
| 1912017567 | Costco Wholesale Corporation | Pharmacy | 29315 Central Ave, Lake Elsinore, CA 92532 | 2006-08-30 |
| 1295095909 | Delago Pharamacy Inc | Pharmacy | 31739 Riverside Dr, Suite J, Lake Elsinore, CA 92530-7818 | 2012-05-29 |
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|---|---|---|---|---|
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| 1023618824 | Ingram's Pharmacy, LLC | Pharmacy | 1115 Union Ave Unit 147-1c, Bakersfield, CA 93307-1050 | 2020-10-29 |
| 1750981874 | Capsule San Francisco LLC | Pharmacy | 475 University Ave, Palo Alto, CA 94301-1814 | 2020-10-28 |
| 1447850623 | Sterling Hatteras LLC | Pharmacy | 916 E Cypress Ave Ste 300, Redding, CA 96002-1038 | 2020-10-28 |
| 1922608454 | Vanessa Ann Marie Rita Pitts | Pharmacy | 26365 Buccaneer Ln, Helendale, CA 92342-7739 | 2020-10-26 |
| 1205435971 | Rinaldi Pharmacy, Inc. | Pharmacy | 11237 Tampa Ave, Porter Ranch, CA 91326-1610 | 2020-10-22 |
| 1467051300 | San Dimas Wellness Pharmacy | Pharmacy | 830 W Arrow Hwy Ste 830b, San Dimas, CA 91773-2498 | 2020-10-21 |
| 1225636889 | Med-plus Pharmacy Inc | Pharmacy | 335 Lindbergh Ave, Livermore, CA 94551-9291 | 2020-10-15 |
| 1689271066 | Innova Pharmacy Iv | Pharmacy | 4815 Watt Ave Ste B101, North Highlands, CA 95660-5108 | 2020-10-08 |
| 1114524683 | Bear Valley Pharmacy | Pharmacy | 17003 Bear Valley Rd Ste B, Hesperia, CA 92345-1420 | 2020-10-07 |
| Find all providers with the same taxonomy | ||||
| City | LAKE ELSINORE |
| Zip Code | 92530 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.