LISKA'S APOTHECARY SHOP, INC. (NPI# 1104479039) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104479039 |
| Entity Type | Organization |
| Organization Name | LISKA'S APOTHECARY SHOP, INC. |
| Practice Address |
1840 Mesquite Ave., Ste. E Lake Havasu City AZ 86403 |
| Practice Telephone | 9828550106 |
| Practice Fax Number | 9288557653 |
| Mailing Telephone | 9828550106 |
| Mailing Fax Number | 9288557653 |
| Enumeration Date | 2019-07-19 |
| Last Update Date | 2019-07-19 |
| Authorized Official Name | ANTHONY ADRIAN LISKA (OWNER/PIC) |
| Authorized Official Telephone | 9288550106 |
| Authorized Official Credential | PHARMD |
| Is Organization Subpart | Y |
| Parent Organization Name | LISKA'S APOTHECARY SHOP, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 300012 | 05 |
| Other Name | Type Code |
|---|---|
| Liska's Apothecary LTC | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164511481 | Liska's Apothecary Shop, Inc. | Pharmacy | 1840 Mesquite Ave, Suite E., Lake Havasu City, AZ 86403-5771 | 2006-10-12 |
| Street Address |
1840 MESQUITE AVE., STE. E |
| City | LAKE HAVASU CITY |
| State | AZ |
| Zip Code | 86403 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275033227 | Ayad Costy | Pharmacist | 75 North Lake Havasu City, Lake Havasu City, AZ 86403 | 2018-02-16 |
| 1942727250 | Ideal Health Care, L.L.C. | Prosthetic/Orthotic Supplier | 1675 Mesquite Ave Ste A, Lake Havasu City, AZ 86403 | 2017-08-28 |
| 1063965036 | Cerner Health Connections, Inc | Clinic/Center | 89 Civic Center Blvd, Lake Havasu City, AZ 86403 | 2016-07-26 |
| 1447643358 | Lundin Dental PC | Durable Medical Equipment & Medical Supplies | 1741 Mesquite Avenue Ste B 100, Lake Havasu City, AZ 86403 | 2015-03-17 |
| 1912301425 | Arizona Havasu Bdm Pak LLC | Dentist | 1799 North Kiowa Blvd, Unit 109, Lake Havasu, AZ 86403 | 2014-10-13 |
| 1386047850 | Emily E Vona | Nurse Practitioner | 84 Acoma Blvd N Ste 104, Lake Havasu City, AZ 86403 | 2014-09-29 |
| 1750700589 | Thomas Wennergren | Pharmacist | 25 S Lake Havasu Ave, Lake Havasu City, AZ 86403 | 2014-04-09 |
| 1285997460 | Jamie L Lemire | Pharmacist | 1980 Mcculloch Blvd, Lake Havasu City, AZ 86403 | 2012-06-21 |
| 1053694448 | Goodwill of Northern Arizona | Exclusive Provider Organization | 1990 Mcculloch Blvd North, Lake Havasu City, AZ 86403 | 2011-09-22 |
| 1114200664 | House On The Riviera Assisted Living | Assisted Living Facility | 190 Riviera Dr., Lake Havasu City, AZ 86403 | 2011-09-21 |
| Find all providers in zip 86403 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538522503 | Sunhaven Assisted Living | Assisted Living Facility | 2731 Jamaica Blvd S, Lake Havasu City, AZ 86406-7770 | 2016-03-29 |
| 1487054292 | Stevens Asisted Living Home | Assisted Living Facility | 871 Thunderbolt Ave, Lake Havasu City, AZ 86406-7803 | 2014-08-28 |
| 1114200664 | House On The Riviera Assisted Living | Assisted Living Facility | 190 Riviera Dr., Lake Havasu City, AZ 86403 | 2011-09-21 |
| 1952607061 | Flowers Assisted Living Inc. | Assisted Living Facility | 3301 Osborn Dr, 101-102, Lake Havasu City, AZ 86406-8993 | 2011-02-07 |
| 1093975310 | Serenity Assisted Living | Assisted Living Facility | 3677 Blue Colt Dr, Lake Havasu City, AZ 86406-4273 | 2008-06-10 |
| 1780719039 | Prestige Assisted Living At Claremont | Assisted Living Facility | 1221 Claremont Dr, Lake Havasu City, AZ 86406-8684 | 2007-02-23 |
| 1609493642 | Gr Lhc, LLC | Assisted Living Facility | 320 Lake Havasu Ave N, Lake Havasu City, AZ 86403-4701 | 2020-06-25 |
| 1790812436 | Lake Havasu Too, LLC | Assisted Living Facility | 1221 Claremont Dr, Lake Havasu City, AZ 86406-8684 | 2007-02-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235730508 | Gheorghe Patrutescu | Assisted Living Facility | 16134 N 72nd Ln, Peoria, AZ 85382-4937 | 2020-11-03 |
| 1942800966 | Yibu Liu | Assisted Living Facility | 3569 E Utopia Rd, Phoenix, AZ 85050-3967 | 2020-10-28 |
| 1386243269 | Harmony House Tucson LLC | Assisted Living Facility | 12651 E Speedway Blvd, Tucson, AZ 85748-2060 | 2020-10-21 |
| 1710586664 | Sunland Springs Memory Care, LLC | Assisted Living Facility | 2415 S Signal Butte Rd, Mesa, AZ 85209-2107 | 2020-10-21 |
| 1487253860 | Ronald Jingco Calaguas | Assisted Living Facility | 2432 W Portobello Ave, Mesa, AZ 85202-7871 | 2020-10-18 |
| 1992303374 | Azi House LLC | Assisted Living Facility | 1200 W Chapala Dr, Tucson, AZ 85704-4521 | 2020-10-16 |
| 1609474030 | Fisher Family Home LLC | Assisted Living Facility | 2927 W Redfield Rd, Phoenix, AZ 85053-7712 | 2020-10-16 |
| 1235736687 | Ana's Assisted Living Home, LLC | Assisted Living Facility | 13238 N 35th St, Phoenix, AZ 85032-6110 | 2020-10-07 |
| 1205433844 | Angelic Care LLC | Assisted Living Facility | 15247 W Wethersfield Rd, Surprise, AZ 85379-9177 | 2020-10-07 |
| 1689281347 | Gilbert Al Partners, Lp | Assisted Living Facility | 1445 E Willis Rd, Gilbert, AZ 85297-7352 | 2020-09-28 |
| Find all providers with the same taxonomy | ||||
| City | LAKE HAVASU CITY |
| Zip Code | 86403 |
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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.