Lakeshore Pharmacies, Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

5301005615 Issued in MI

Legal business name

LAKESHORE PHARMACIES, INC

Doing business as

Alexander's Drug Store

Practice address

211 East Main Street
Fennville, MI 49408

Phone

(269) 561-4411

Fax

(269) 561-5474

NPI assigned

Aug 9, 2006

Last updated

Jul 17, 2015By 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

Mr. Daniel Mark Alexander, RPH.NPI 1407941693

Title

President/Ceo

Phone

(269) 561-4411

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Alexander's Drug Store Doing business as

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Lakeshore Pharmacies, Inc.

  dba Allegan Community Pharmacy

  • Community/Retail Pharmacy
  • Allegan, MI
  • NPI 1225048978

  O20210121000583

  Same enrollment
• Lakeshore Pharmacies, Inc.

  dba Saugatuck Drug

  • Community/Retail Pharmacy
  • Saugatuck, MI
  • NPI 1962412817

  O20210121000583

  Same enrollment

Tax ID family

Alexander's Drug Store3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Lakeshore Pharmacies, Inc.

  dba Allegan Community Pharmacy

  • Community/Retail Pharmacy
  • Allegan, MI
  • NPI 1225048978
  NPD tax ID
• Lakeshore Pharmacies, Inc.

  dba Saugatuck Drug

  • Community/Retail Pharmacy
  • Saugatuck, MI
  • NPI 1962412817
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Daniel Mark Alexander, RPH

  • Pharmacist
  • Fennville, MI
  • NPI 1407941693
  NPD (past) Authorized official

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437091200000",
    "number": "1487664330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 28",
            "city": "FENNVILLE",
            "state": "MI",
            "postal_code": "49408",
            "telephone_number": "269-561-4411",
            "fax_number": "269-561-5474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 EAST MAIN STREET",
            "city": "FENNVILLE",
            "state": "MI",
            "postal_code": "49408",
            "telephone_number": "269-561-4411",
            "fax_number": "269-561-5474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESHORE PHARMACIES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-09",
        "last_updated": "2015-07-17",
        "status": "A",
        "authorized_official_last_name": "ALEXANDER",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "MARK",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "269-561-4411",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301005615",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "2349733",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2349733",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "2349733",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Alexander's Drug Store",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Dennis Anthony Icabone, DDS
• Karing Conversations
• Kaitlyn Kelly, LLMSW
• Kenneth Earl Kratzer (Fennville Family Medicine)
• Curtis A. Lacy, L.P.C.
• Lakeside Smiles, PLLC
• Hugh Cameron Little Sr., P.T.
• McAp Fennville Opco LLC
• James Peter Motiff, PH.D.
• Jennifer L Rewa, OT

• Community/Retail Pharmacy in Fennville, MI
• Providers in Fennville, MI by specialty
• Community/Retail Pharmacy in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2015; 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.