Shands at Lake Shore Inc
NPI 1366538175ActiveOrganization· Pharmacy· Lake City, FL
Pharmacy in Lake City, Florida, registered in NPPES in October 2006, part of Shands at Lake Shore Inc. The authorized official on file is Jodi Mansfield, Sr. Vice President & Coo.
Overview
| NPI | 1366538175 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | Shands at Lake Shore Inc |
| NPI issued | Oct 5, 2006 |
| Last updated in NPPES | Nov 20, 2007 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Pharmacy Primary | 333600000X | 4258 | FL |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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