LAKESIDE MEMORIAL HOSPITAL INC (NPI# 1225071566) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225071566 |
| Entity Type | Organization |
| Organization Name | LAKESIDE MEMORIAL HOSPITAL INC |
| Other Organization Name | LAKESIDE MEMORIAL HOSP PHCY INC |
| Practice Address |
156 West Ave Brockport NY 14420-1229 |
| Practice Telephone | 5853956043 |
| Practice Fax Number | 5853956022 |
| Mailing Telephone | 5853956043 |
| Mailing Fax Number | 5853956022 |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2013-01-07 |
| Authorized Official Name | CHRISTOPHER DAILEY (DIRECTOR FO PHARMACY) |
| Authorized Official Telephone | 5853956043 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers | ||
| N | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
Suppliers | ||
| Y | 3336I0012X |
Pharmacy Specialization: Institutional Pharmacy |
012799 | NY | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NCPDP PROVIDER IDENTIFICATION NUMBER | 3349037 | 01 | |
| NY | 00279543 | 05 |
| Other Name | Type Code |
|---|---|
| LAKESIDE MEMORIAL HOSP PHCY INC | Doing Business As Name - Organization |
| Street Address |
156 WEST AVE |
| City | BROCKPORT |
| State | NY |
| Zip Code | 14420-1229 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942271218 | Didem Miraloglu | Internal Medicine | 156 West Ave, Suite 106, Brockport, NY 14420-1229 | 2006-01-27 |
| 1679170849 | Kelsey Covel | Nurse Practitioner | 156 West Ave, Brockport, NY 14420-1229 | 2020-10-01 |
| 1720624562 | Geena Brady | Physical Therapist | 156 West Ave, Brockport, NY 14420-1229 | 2019-11-26 |
| 1801366380 | University Orthopaedic Associates of Rochester | Orthopaedic Surgery | 156 West Ave, Brockport, NY 14420-1229 | 2018-11-28 |
| 1508302159 | Melissa Kingston | Occupational Therapist | 156 West Ave, Brockport, NY 14420-1229 | 2017-01-06 |
| 1043769326 | Emma L Leatham | Physician Assistant | 156 West Ave, Brockport, NY 14420-1229 | 2016-09-27 |
| 1679811327 | Lakeside Health System | General Acute Care Hospital | 156 West Ave, Brockport, NY 14420-1229 | 2013-01-30 |
| 1801173448 | Lakeshore Surgical Practice, PC | Surgery | 156 West Ave, Brockport, NY 14420-1229 | 2011-11-10 |
| 1952613499 | Nathaniel James Wade | Pharmacist | 156 West Ave, Pharmacy Dept, Brockport, NY 14420-1229 | 2010-07-13 |
| 1235457375 | Suri Karthikeyan Mdpc | Internal Medicine | 156 West Ave, Suite 202, Brockport, NY 14420-1229 | 2010-05-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194217471 | Brianna Lynn Bunch | Licensed Practical Nurse | 126 White Road, Brockport, NY 14420 | 2018-06-03 |
| 1174012785 | Penny Bowers | Massage Therapist | 27 Market Street, Upstairs, Brockport, NY 14420 | 2018-05-09 |
| 1386172062 | Allison Manly | Dentist | 1000 Transit Way, Brockport, NY 14420 | 2017-05-25 |
| 1235518143 | Erin B Chapman | Physical Medicine & Rehabilitation | 350 New Campus Drive, Brockport, NY 14420 | 2015-05-26 |
| 1972853653 | Theresa Fox Lehman | Specialist | 32 Mission Hill Drive, Brockport, NY 14420 | 2012-09-11 |
| 1689946303 | Beverly Whiteman | Registered Nurse | 40 Allen St., Brockport, NY 14420 | 2012-01-27 |
| 1316217425 | Julie Ann Knapp | Registered Nurse | 40 Allen Street, Brockport Central School District, Brockport, NY 14420 | 2012-01-05 |
| 1851678965 | Jennifer Anne Cohen | Registered Nurse | 188 Utica Street, Brockport, NY 14420 | 2011-11-03 |
| 1205088960 | Amy Maureen Hennessy | Obstetrics & Gynecology | 6668 Fourth Section Rd Ste 500, Brockport, NY 14420 | 2008-10-14 |
| 1053454884 | Nancy S Iafrati | Nurse Practitioner | Suny Brockport Student Health Center, 350 New Campus Drive, Brockport, NY 14420 | 2007-02-14 |
| Find all providers in zip 14420 | ||||
| Taxonomy Code | 3336I0012X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Institutional Pharmacy |
| A pharmacy in a hospital (inpatient) or institution used by pharmacists for the compounding and delivery of medicinal preparations to be administered to the patient by nursing or other authorized personnel. Institutional Pharmacies also counsel patients and caregivers; 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 |
|---|---|---|---|---|
| 1013495423 | Parkview Niagara Street, LLC | Pharmacy | 1050 Niagara Street, Suite 110, Buffalo, NY 14213-2007 | 2018-07-30 |
| 1467822163 | New York City Health and Hospitals Corp | Pharmacy | 275 Atlantic Ave, Brooklyn, NY 11201-5714 | 2015-10-07 |
| 1053713883 | State of New York | Pharmacy | Cook St, Dannemora, NY 12929 | 2014-09-24 |
| 1376945618 | Pine Pharmaceuticals, LLC | Pharmacy | 100 Colvin Woods Pkwy Ste 300, Tonawanda, NY 14150-6974 | 2014-09-18 |
| 1851714752 | College of Veterinary Medicine | Pharmacy | Cornell University Phcy-vmc Bldg, Tower Rd, Ithaca, NY 14853 | 2014-01-28 |
| 1649318767 | Thales Well Pharmacy Inc | Pharmacy | 1785 New York Ave, Huntington Station, NY 11746-1727 | 2007-02-01 |
| 1154488476 | United Health Services, Inc. | Pharmacy | 10 42 Mitchell Ave, Binghamton, NY 13903-1602 | 2007-01-03 |
| 1134137375 | New York City Health and Hospitals Corporation | Pharmacy | 545 E 142nd St, Bronx, NY 10454-2110 | 2006-08-03 |
| 1427063270 | New York City Health and Hospitals Corporation | Pharmacy | 234 E 149th St Rm 2a1, Bronx, NY 10451-5504 | 2006-07-30 |
| 1437783461 | Christina Bumbalo | Pharmacy | 565 Abbott Rd, Buffalo, NY 14220-2039 | 2020-02-28 |
| Find all providers with the same taxonomy | ||||
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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.