Parkside Pharmacy Inc

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

License

60002772A Issued in IN

Legal business name

PARKSIDE PHARMACY INC

Practice address

2200 Ferry St
Lafayette, IN 47904-3016

Phone

(765) 447-1000

Fax

(765) 447-4714

NPI assigned

May 19, 2006

Last updated

Aug 15, 2016By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Randall L Gerhart, BS PHARMACY

Title

Owner Pharmacist

Phone

(765) 447-1000

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471219200000",
    "number": "1063465904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 FERRY ST",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479043016",
            "telephone_number": "765-447-1000",
            "fax_number": "765-447-4714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 FERRY ST",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479043016",
            "telephone_number": "765-447-1000",
            "fax_number": "765-447-4714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARKSIDE PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-19",
        "last_updated": "2016-08-15",
        "status": "A",
        "authorized_official_last_name": "GERHART",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER PHARMACIST",
        "authorized_official_telephone_number": "765-447-1000",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "BS PHARMACY"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "IN",
            "license": "60002772A",
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "IN",
            "license": "60002772A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100301510A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lylan S. Park, MD
• Megan Parke, MS, CCC-SLP
• Brent Alan Parker, MD
• Emilie D Parker, CST
• Holly Parkison, RBT
• Parkside Pharmacy Inc
• Sally A Parman, R.N
• Chloe Parsons, RBT
• Jana M Parsons, PMHNP
• Roshini Durga Paruchuri, DDS

• Long Term Care Pharmacy in Lafayette, IN
• Providers in Lafayette, IN by specialty
• Long Term Care Pharmacy in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.