NPIMap

Organization Active NPI

Livonia Lakeville Pharmacy Inc

  • Community/Retail Pharmacy
  • Lakeville, NY
National Provider Identifier
1689736746
Registry record updated Jun 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
024333 Issued in NY
Legal business name
LIVONIA LAKEVILLE PHARMACY INC
Practice address
5975 Big Tree Rd
Lakeville, NY 14480-0414
Phone
(585) 346-5615
Fax
(585) 346-2212
NPI assigned
Dec 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2013

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

Authorized official

Name
Jennifer Burke
Title
Vice President
Phone
(585) 346-5615

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 024333 NY Primary
Compounding Pharmacy 3336C0004X

Addresses

Primary practice location

5975 Big Tree Rd
Lakeville, NY 14480-0414

Mailing address

PO Box 414
Lakeville, NY 14480-0414

Other identifiers 2

IdentifierTypeStateIssuer
1944178MedicaidNY
2064266OtherPK

Other names 1

  • LIVONIA PHARMACY Doing business as

National Provider Directory

National Provider Directory

Locations

5975 Big Tree Rd
Lakeville, NY 14480
Phone (585) 346-5615

Practitioners & affiliated clinicians

Practitioners 5

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": "1166140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1371686400000",
    "number": "1689736746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 414",
            "city": "LAKEVILLE",
            "state": "NY",
            "postal_code": "144800414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5975 BIG TREE RD",
            "city": "LAKEVILLE",
            "state": "NY",
            "postal_code": "144800414",
            "telephone_number": "585-346-5615",
            "fax_number": "585-346-2212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVONIA LAKEVILLE PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-15",
        "last_updated": "2013-06-20",
        "status": "A",
        "authorized_official_last_name": "BURKE",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "585-346-5615"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "024333",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1944178",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2064266",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LIVONIA PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lakeville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2013; 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.