Active NPI
Lawrence Dean Stidham, RPH
- Pharmacist
- Lake Placid, FL
National Provider Identifier
1740495779
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS0019943
- Practice address
- 224 E Interlake Blvd
Lake Placid, FL 33852-9603 - Phone
- (863) 465-2291
- NPI assigned
- May 12, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PS0019943 | FL | Primary |
Addresses
Primary practice location
224 E Interlake Blvd
Lake Placid, FL 33852-9603
Mailing address
2950 Placid View Dr
Lake Placid, FL 33852-5028
Phone (863) 465-6448
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS0019943 | FL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lake Placid Drug Co. | Pharmacist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Pharmacist
- Lake Placid, FL
- NPI 1790784346
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178928000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1740495779",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2950 PLACID VIEW DR",
"city": "LAKE PLACID",
"state": "FL",
"postal_code": "338525028",
"telephone_number": "863-465-6448"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "224 E INTERLAKE BLVD",
"city": "LAKE PLACID",
"state": "FL",
"postal_code": "338529603",
"telephone_number": "863-465-2291"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STIDHAM",
"first_name": "LAWRENCE",
"middle_name": "DEAN",
"name_prefix": "Mr.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS0019943",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake Placid, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.