Lakeside Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

13756 Issued in NC

Legal business name

LAKESIDE PHARMACY LLC

Practice address

9615 Sherrill Estates Rd Ste B
Huntersville, NC 28078-6552

Phone

(980) 441-8600

Fax

(980) 444-8625

NPI assigned

Jun 11, 2018

Organization subpart

No

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

Authorized official

Name

Thanveer Reddy Gadwal, PHARMDNPI 1932694262

Title

Manager

Phone

(980) 441-8600

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• Lakeside Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

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

• Thanveer Reddy Gadwal, PHARMD

  • Pharmacist
  • Huntersville, NC
  • NPI 1932694262
  NPD Authorized official

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

{
    "created_epoch": "1528675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761868800000",
    "number": "1245723725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9615 SHERRILL ESTATES RD",
            "address_2": "SUITE B",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280786552",
            "telephone_number": "980-441-8600",
            "fax_number": "980-444-8625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9615 SHERRILL ESTATES RD STE B",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280786552",
            "telephone_number": "980-441-8600",
            "fax_number": "980-444-8625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESIDE PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-11",
        "last_updated": "2025-10-31",
        "certification_date": "2025-10-31",
        "status": "A",
        "authorized_official_last_name": "GADWAL",
        "authorized_official_first_name": "THANVEER",
        "authorized_official_middle_name": "REDDY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "980-441-8600",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NC",
            "license": "13756",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1245723725",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7Z1352",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2177949",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lakeside Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lake Norman Psychological Services PLLC
• Lake Norman Treatment Associates, LLC
• Josephine H Lake, MD
• Lakeshore Counseling and Coaching
• Lakeside Health & Rehab Center, LLC
• Mani Lama, MD
• Korie Dewire Lambert
• Morgan Lammando, PT, DPT
• Brenda King Landau, NP
• Chase Landers, ATC

• Community/Retail Pharmacy in Huntersville, NC
• Providers in Huntersville, NC by specialty
• Community/Retail Pharmacy in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.