Lakeside Pharmacy, LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

008517 Issued in GA

Legal business name

LAKESIDE PHARMACY, LLC

Doing business as

Lakeside Pharmacy

Practice address

1505 Northside Blvd Ste 1600
Cumming, GA 30041-7660

Phone

(770) 205-0290

Fax

(770) 205-7386

NPI assigned

Mar 12, 2007

Last updated

May 7, 2025By 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

Dr. Apollon Anthony Constantinides Jr., PHARM D

Title

President

Phone

(770) 205-0290

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Lakeside Pharmacy Doing business as

Locations

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

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746576000000",
    "number": "1437281847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1505 NORTHSIDE BLVD STE 1600",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300417660",
            "telephone_number": "770-205-0290",
            "fax_number": "770-205-7386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 NORTHSIDE BLVD STE 1600",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300417660",
            "telephone_number": "770-205-0290",
            "fax_number": "770-205-7386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESIDE PHARMACY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-12",
        "last_updated": "2025-05-07",
        "certification_date": "2025-05-07",
        "status": "A",
        "authorized_official_last_name": "CONSTANTINIDES",
        "authorized_official_first_name": "APOLLON",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-205-0290",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "PHARM D"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "GA",
            "license": "008517",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00913811A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lakeside Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Man Fung Lam, PHD., BCBA-D
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• Ashley Mitchell Lamb, CNP
• James Woodrow Lamb III, D.M.D., M.S.
• Megan Lambert

• Community/Retail Pharmacy in Cumming, GA
• Providers in Cumming, GA by specialty
• Community/Retail Pharmacy in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2025; 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.