NPIMap

Organization Active NPI

Lake City Pharmacy Inc

  • Long Term Care Pharmacy
  • Lake City, FL
National Provider Identifier
1346261237
Registry record updated Jul 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
License
PH21845 Issued in FL
Legal business name
LAKE CITY PHARMACY INC
Practice address
376 SW Alachua Ave
Lake City, FL 32025-5201
Phone
(386) 758-3460
Fax
(386) 758-3462
NPI assigned
Jul 23, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2009

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

Authorized official

Name
Mr. Joel Eric Rosenfeld, RPH
Title
Owner/Manager
Phone
(386) 758-6770

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X PH21845 FL
Long Term Care Pharmacy 3336L0003X PH21845 FL Primary

Addresses

Primary practice location

376 SW Alachua Ave
Lake City, FL 32025-5201

Mailing address

376 SW Alachua Ave
Lake City, FL 32025-5201
Phone (386) 758-3460

Other identifiers 2

IdentifierTypeStateIssuer
031645801MedicaidFL
1018616OtherNCPDP PROVIDER IDENTIFICATION NUMBER

Other names 1

  • LAKE CITY PHARMACY INC Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1153612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1247702400000",
    "number": "1346261237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "376 SW ALACHUA AVE",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320255201",
            "telephone_number": "386-758-3460",
            "fax_number": "386-758-3462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "376 SW ALACHUA AVE",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320255201",
            "telephone_number": "386-758-3460",
            "fax_number": "386-758-3462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE CITY PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-23",
        "last_updated": "2009-07-16",
        "status": "A",
        "authorized_official_last_name": "ROSENFELD",
        "authorized_official_first_name": "JOEL",
        "authorized_official_middle_name": "ERIC",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "386-758-6770",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "FL",
            "license": "PH21845",
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "FL",
            "license": "PH21845",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "031645801",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "1018616",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LAKE CITY PHARMACY INC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lake City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2009; 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.