LAKE SHORE DRUGS LLC (NPI# 1518328038) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518328038 |
| Entity Type | Organization |
| Organization Name | LAKE SHORE DRUGS LLC |
| Other Organization Name | MIKE'S PHARMACY II |
| Practice Address |
3820 Mountain Rd Unit G Pasadena MD 21122-2027 |
| Practice Telephone | 4102550099 |
| Practice Fax Number | 4102550799 |
| Mailing Telephone | 4102550099 |
| Mailing Fax Number | 4102550799 |
| Enumeration Date | 2016-03-10 |
| Last Update Date | 2016-06-09 |
| Authorized Official Name | SHALENDRA CHERUKURI (MEMBER) |
| Authorized Official Telephone | 4102550099 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers | ||
| Y | 333600000X | Pharmacy | P07151 | MD | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2159782 | 01 |
| Other Name | Type Code |
|---|---|
| Mike's Pharmacy II | Doing Business As Name - Organization |
| Street Address |
3820 MOUNTAIN RD UNIT G |
| City | PASADENA |
| State | MD |
| Zip Code | 21122-2027 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740889211 | Hyunji Lee | Pharmacist | 8107 Governor Ritchie Highway, Pasadena, MD 21122 | 2020-10-25 |
| 1538712625 | Liri Fusha | Clinic/Center | 8221 Richie Hwy Suit #102, Pasadena, MD 21122 | 2019-07-18 |
| 1730649922 | Barrett Arthur Tollenger | Counselor | 2825 Mountain Road, Suite 204, Pasadena, MD 21122 | 2019-03-22 |
| 1750849543 | Bradley J Spoon | Counselor | 8028 Ritchie Highway St. 312, Pasadena, MD 21122 | 2019-03-11 |
| 1366916553 | Brittney Byrd | Behavior Technician | 7759 Middlegate Ct, Pasadena, MD 21122 | 2019-01-22 |
| 1780154310 | Amanda Ann Zeller | Speech-Language Pathologist | 8515 Jenkins Road, Pasadena, MD 21122 | 2018-11-27 |
| 1225531544 | Anne Arundel-sca Surgicenter, LLC | Clinic/Center | 8109 Ritchie Hwy Ste 250, Pasadena, MD 21122 | 2018-03-13 |
| 1629577424 | Anne Arundel Physician Group, LLC | Obstetrics & Gynecology | 18 Magothy Beach Road Suite A, Pasadena, MD 21122 | 2018-02-07 |
| 1063968261 | Chinedu Ikpemo | Pharmacist | 8051 Fort Smallwood Rd, Pasadena, MD 21122 | 2016-08-28 |
| 1053728634 | Wisecare, LLC | Clinic/Center | 33 Magothy Beach Rd, Suite 102-103, Pasadena, MD 21122 | 2014-07-16 |
| Find all providers in zip 21122 | ||||
| Taxonomy Code | 333600000X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. |
| 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: added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891244430 | Precisionmeds Services Inc. | Pharmacy | 638 E Colorado Blvd, Suite 202, Pasadena, CA 91101-2006 | 2016-09-23 |
| 1174079701 | Cvs | Pharmacy | 3883 E. Foothill Blvd, Pasadena, CA 91107 | 2016-09-01 |
| 1447653787 | Community Health Alliance of Pasadena | Pharmacy | 1855 N Fair Oaks Ave Ste 100, Pasadena, CA 91103-1620 | 2014-10-01 |
| 1104166552 | Riviera Drugs LLC | Pharmacy | 8541 Fort Smallwood Rd, Unit G, Pasadena, MD 21122-2676 | 2013-02-21 |
| 1679863575 | Burke Family Pharmacy Inc | Pharmacy | 722 Fairmont Pkwy, Pasadena, TX 77504-2804 | 2011-04-12 |
| 1023328374 | O&w Interests LLC | Pharmacy | 3954 Spencer Hwy, Pasadena, TX 77504-1206 | 2010-10-19 |
| 1386717817 | Kroger Texas L P | Pharmacy | 3550 Spencer Hwy, Pasadena, TX 77504-1110 | 2006-11-15 |
| 1285707711 | Kroger Texas L P | Pharmacy | 2619 Red Bluff Rd, Pasadena, TX 77506-5270 | 2006-11-15 |
| 1336230010 | Diran B.bahadourian | Pharmacy | 1864 E Washington Blvd, Suite #105, Pasadena, CA 91104-1647 | 2006-09-27 |
| 1831299874 | 986 Specialty Pharmacy Pasadena Inc | Pharmacy | 1719 E. Walnut St., Pasadena, CA 91106-1611 | 2006-09-22 |
| Find all providers in PASADENA | ||||
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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.