NPIMap

Organization Active NPI

Liska'S Apothecary Shop, Inc.

  • Assisted Living Facility
  • Lake Havasu City, AZ
National Provider Identifier
1104479039
Registry record updated May 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
LISKA'S APOTHECARY SHOP, INC.
Practice address
1840 Mesquite Ave., Ste. E
Lake Havasu City, AZ 86403
Phone
(982) 855-0106
Fax
(928) 855-7653
NPI assigned
Jul 19, 2019
Organization subpart
Yes
Parent organization
LISKA'S APOTHECARY SHOP, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on May 21, 2026

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

Authorized official

Name
Sheryl Ann Pringle
Title
Office Manager
Phone
(928) 855-0106

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X Primary

Addresses

Primary practice location

1840 Mesquite Ave., Ste. E
Lake Havasu City, AZ 86403

Mailing address

1840 Mesquite Ave Ste E
Lake Havasu City, AZ 86403-5771
Phone (982) 855-0106

Other identifiers 1

IdentifierTypeStateIssuer
300012MedicaidAZ

Other names 1

  • Liska's Apothecary LTC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Liskas Apothcary Shop Inc2 organizations share this tax ID, including this one
Part of
Liskas Apothcary Shop Inc

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1840 Mesquite Ave
Ste E
Lk Havasu Cty, AZ 86403
Phone (928) 855-0106

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1563494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1779321600000",
    "number": "1104479039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1840 MESQUITE AVE STE E",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864035771",
            "telephone_number": "982-855-0106",
            "fax_number": "928-855-7653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1840 MESQUITE AVE., STE. E",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "86403",
            "telephone_number": "982-855-0106",
            "fax_number": "928-855-7653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LISKA'S APOTHECARY SHOP, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LISKA'S APOTHECARY SHOP, INC.",
        "enumeration_date": "2019-07-19",
        "last_updated": "2026-05-21",
        "certification_date": "2026-05-21",
        "status": "A",
        "authorized_official_last_name": "PRINGLE",
        "authorized_official_first_name": "SHERYL",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "928-855-0106"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300012",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Liska's Apothecary LTC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lake Havasu City, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.