NPIMap

Organization Active NPI

Luxbury Ventures LLC

Doing business as Oakside Care Pharmacy

  • Community/Retail Pharmacy
  • Reading, PA
National Provider Identifier
1457690026
Registry record updated Oct 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PP482357 Issued in PA
Legal business name
LUXBURY VENTURES LLC
Doing business as
Oakside Care Pharmacy
Practice address
440 Lehigh St
Reading, PA 19601-1750
Phone
(484) 663-5760
Fax
(610) 378-9000
NPI assigned
Feb 2, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2023

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

Authorized official

Name
Fadeke Salako, B.PHARMNPI 1770702128
Title
Pharmacy Manager
Phone
(484) 663-5760

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X PP482357 PA Primary

Addresses

Primary practice location

440 Lehigh St
Reading, PA 19601-1750

Mailing address

422 Augusta Dr E
Reading, PA 19608-2128

Other identifiers 2

IdentifierTypeStateIssuer
1028072400001MedicaidPA
2140155OtherPK

Other names 1

  • Oakside Care Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20131029000777 PA Part B Supplier - Mass Immunization (Roster Biller Only) 5991930984 Practice locations: Reading, PA
O20140909001330 PA DME Supplier - Pharmacy 5991930984 Practice locations: Reading, PA

National Provider Directory

National Provider Directory
Tax ID family
Luxbury Ventures LLC2 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.

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 1

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": "1359763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696118400000",
    "number": "1457690026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "422 AUGUSTA DR E",
            "city": "READING",
            "state": "PA",
            "postal_code": "196082128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 LEHIGH ST",
            "city": "READING",
            "state": "PA",
            "postal_code": "196011750",
            "telephone_number": "484-663-5760",
            "fax_number": "610-378-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUXBURY VENTURES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-02",
        "last_updated": "2023-10-01",
        "certification_date": "2023-10-01",
        "status": "A",
        "authorized_official_last_name": "SALAKO",
        "authorized_official_first_name": "FADEKE",
        "authorized_official_title_or_position": "PHARMACY MANAGER",
        "authorized_official_telephone_number": "484-663-5760",
        "authorized_official_credential": "B.PHARM"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "PA",
            "license": "PP482357",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1028072400001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2140155",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Oakside Care Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Reading, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2023; 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.