NPIMap

Organization Active NPI

Dadeville Pharmacy LLC

Doing business as Lakeshore Discount Pharmacy

  • Pharmacy
  • Dadeville, AL
National Provider Identifier
1932967908
Registry record updated Mar 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
Legal business name
DADEVILLE PHARMACY LLC
Doing business as
Lakeshore Discount Pharmacy
Practice address
221 E South St
Dadeville, AL 36853-1923
Phone
(256) 825-0063
Fax
(256) 825-5584
NPI assigned
Mar 13, 2024
Last updated
Mar 13, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2024

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

Authorized official

Name
Joe A Dalton
Title
Owner
Phone
(256) 825-0063

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X NU Primary

Addresses

Primary practice location

221 E South St
Dadeville, AL 36853-1923

Mailing address

221 E South St
Dadeville, AL 36853-1923
Phone (256) 825-0063

Other identifiers 1

IdentifierTypeStateIssuer
226751MedicaidAL

Other names 1

  • Lakeshore Discount Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dadeville Pharmacy 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.

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1710288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710288000000",
    "number": "1932967908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 E SOUTH ST",
            "city": "DADEVILLE",
            "state": "AL",
            "postal_code": "368531923",
            "telephone_number": "256-825-0063",
            "fax_number": "256-825-5584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 E SOUTH ST",
            "city": "DADEVILLE",
            "state": "AL",
            "postal_code": "368531923",
            "telephone_number": "256-825-0063",
            "fax_number": "256-825-5584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DADEVILLE PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-13",
        "last_updated": "2024-03-13",
        "certification_date": "2024-03-13",
        "status": "A",
        "authorized_official_last_name": "DALTON",
        "authorized_official_first_name": "JOE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "256-825-0063"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "226751",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lakeshore Discount Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dadeville, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2024; 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.