Lake City Pharmacy, LLC

Primary specialty

PharmacyTaxonomy code 333600000X

License

5301011132 Issued in MI

Legal business name

LAKE CITY PHARMACY, LLC

Practice address

33389 Van Dyke Ave
Sterling Heights, MI 48312

Phone

(586) 315-1200

Fax

(866) 902-3981

NPI assigned

Jan 26, 2017

Organization subpart

No

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

Authorized official

Name

Anne Marie Ange

Title

Pharmacist in Charge/ Managing Empl

Phone

(586) 315-1200

Specialties & licenses 3

Addresses

Locations

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

{
    "created_epoch": "1485388800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1535414400000",
    "number": "1679010763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33389 VAN DYKE AVE",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483125926",
            "telephone_number": "586-315-1200",
            "fax_number": "866-902-3981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33389 VAN DYKE AVE",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "48312",
            "telephone_number": "586-315-1200",
            "fax_number": "866-902-3981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE CITY PHARMACY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-26",
        "last_updated": "2018-08-28",
        "status": "A",
        "authorized_official_last_name": "ANGE",
        "authorized_official_first_name": "ANNE",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "PHARMACIST IN CHARGE/ MANAGING EMPL",
        "authorized_official_telephone_number": "586-315-1200"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "MI",
            "license": "5301011132",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Autumn Lacross
• Yvonne Lynn Lafave, FNP-BC
• Amy Laird, PTA
• Mandy Laird
• Laith Potrous MD PLLC
• Micah Lake
• Lakeshore Ear Nose and Throat Center PC
• Lakeside Foot and Leg Care PLLC
• Lakeside Manor Nursing & Rehabilitation Center LLC
• Kathleen Ryan Lalonde, ATC

• All providers in Sterling Heights, MI
• Pharmacy in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2018; 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.