Shri Lake Shore Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

28RS00761500 Issued in NJ

Legal business name

SHRI LAKE SHORE PHARMACY LLC

Doing business as

Lake Shore Pharmacy

Practice address

299 Parsippany Rd
Parsippany, NJ 07054-5176

Phone

(862) 701-5808

Fax

(862) 701-5809

NPI assigned

Apr 12, 2018

Organization subpart

No

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

Authorized official

Name

Muhammad Adeel

Title

Owner

Phone

(862) 701-5808

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Lake Shore Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in NJ3 enrollments

Enrollment records 3

Tax ID family

Lake Shore Pharmacy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Shri Lake Shore Pharmacy LLC

  dba Lake Shore Pharmacy

  • Long Term Care Pharmacy
  • Parsippany, NJ
  • NPI 1003626342
  NPD tax ID

Practitioners 2

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

• Padmini Persaud, PHARMD

  • Pharmacist
  • Parsippany, NJ
  • NPI 1134840838
  NPD
• Preni Nair

  • Pharmacist
  • Parsippany, NJ
  • NPI 1366929291
  NPD (past)

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

{
    "created_epoch": "1523491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724198400000",
    "number": "1417454703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "299 PARSIPPANY RD",
            "city": "PARSIPPANY",
            "state": "NJ",
            "postal_code": "070545176",
            "telephone_number": "862-701-5808",
            "fax_number": "862-701-5809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "299 PARSIPPANY RD",
            "city": "PARSIPPANY",
            "state": "NJ",
            "postal_code": "070545176",
            "telephone_number": "862-701-5808",
            "fax_number": "862-701-5809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHRI LAKE SHORE PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-12",
        "last_updated": "2024-08-21",
        "certification_date": "2024-08-21",
        "status": "A",
        "authorized_official_last_name": "ADEEL",
        "authorized_official_first_name": "MUHAMMAD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "862-701-5808"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NJ",
            "license": "28RS00761500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2176787",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lake Shore Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Amy Sheppard
• Shyam Sheth, DPM
• Shetland Counseling, LLC
• Jalpa Shingala
• Shri Lake Shore Pharmacy LLC (Lake Shore Pharmacy)
• Shri Yamunajee LLC (Troy Hills Pharmacy)
• Tianna Marlia Sianipar
• Silver Pain LLC
• Kesha Simmons
• Danielle Marie Simon, MS, CCC-SLP

• Community/Retail Pharmacy in Parsippany, NJ
• Providers in Parsippany, NJ by specialty
• Community/Retail Pharmacy in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2024; 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.