NPIMap

Organization Active NPI

Lakeshore Pharmacies, Inc.

Doing business as Saugatuck Drug

  • Community/Retail Pharmacy
  • Saugatuck, MI
National Provider Identifier
1962412817
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
5301005599 Issued in MI
Legal business name
LAKESHORE PHARMACIES, INC.
Doing business as
Saugatuck Drug
Practice address
201 Butler St.
Saugatuck, MI 49453
Phone
(269) 857-2300
Fax
(269) 857-1874
NPI assigned
Aug 9, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Daniel Mark Alexander, PHARMACISTNPI 1407941693
Title
President
Phone
(269) 857-2300

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 5301005599 MI Primary

Addresses

Primary practice location

201 Butler St.
Saugatuck, MI 49453

Mailing address

201 Butler St.
PO Box 188
Saugatuck, MI 49453
Phone (269) 857-2300

Other identifiers 1

IdentifierTypeStateIssuer
2349618OtherMINCPDP

Other names 1

  • Saugatuck Drug Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210121000583 MI Part B Supplier - Mass Immunization (Roster Biller Only) 5496169153 2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Allegan, MI; Saugatuck, MI; Fennville, MI

Other NPIs on the same Medicare enrollment 2

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

National Provider Directory

National Provider Directory
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.

Practitioners & affiliated clinicians

Practitioners 2

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": "1155081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1962412817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 BUTLER ST.",
            "address_2": "PO BOX 188",
            "city": "SAUGATUCK",
            "state": "MI",
            "postal_code": "49453",
            "telephone_number": "269-857-2300",
            "fax_number": "269-857-1874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 BUTLER ST.",
            "city": "SAUGATUCK",
            "state": "MI",
            "postal_code": "49453",
            "telephone_number": "269-857-2300",
            "fax_number": "269-857-1874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESHORE PHARMACIES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ALEXANDER",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "MARK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "269-857-2300",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PHARMACIST"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301005599",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "2349618",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Saugatuck Drug",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saugatuck, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.