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PARKSIDE PHARMACY INC
NPI 1063465904
Pharmacy - Long Term Care Pharmacy in Lafayette, IN

Active since May 19, 2006
2200 FERRY ST, LAFAYETTE, IN 47904(765) 447-1000(765) 447-4714 Get Directions Write a Review

NPPES record last updated: August 15, 2016. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Parkside Pharmacy Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PARKSIDE PHARMACY INC (NPI 1063465904) is a healthcare organization registered as a long term care pharmacy in Lafayette, Indiana and active in the NPI registry since May 2006. The organization lists Randall L Gerhart, Owner Pharmacist, as its authorized official.

NPPES Registry Identity

NPI1063465904
Entity TypeOrganization
Primary Taxonomy3336L0003X
Legal Business NamePARKSIDE PHARMACY INC
Location Address2200 FERRY STLafayette, IN 47904-3016
Mailing Address2200 Ferry StLafayette, IN 47904-3016 · (765) 447-1000 · Fax (765) 447-4714
Phone(765) 447-1000
Fax(765) 447-4714
Organization SubpartNo
Authorized OfficialRandall L GerhartOwner Pharmacist · (765) 447-1000
Enumeration DateMay 19, 2006
Last NPPES UpdateAugust 15, 2016
✔ NPI 1063465904 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPharmacy · Long Term Care PharmacySuppliers
Taxonomy Code3336L0003X
License✔ Licensed in IN · 60002772A
Definition
A pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements.
Also ListedPharmacyTaxonomy 333600000X · License 60002772A (IN)
2200 FERRY ST, Lafayette, IN 47904
Open in Google Maps ↗

Other Identifiers 2

Medicare NSC0208670001IN
Medicaid100301510AIN

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter from Arkansas Health & Wellness and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and revalidation status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Parkside Pharmacy Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by March 31, 2027

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateIndianaEnrollment IDO20100112000672Non-DME Part B · Mass Immunization (Roster Biller Only)Due dateMarch 31, 2027
Source: CMS Revalidation Due Date List, October 2026 release.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
122 services122 patients
Influenza vaccine, inactivated 90653
The Influenza vaccine, inactivated, is a shot given to protect against the flu. It contains killed virus particles that help your body build immunity to the flu. It's recommended annually to keep your protection up-to-date. It's safe for ages 6 months and up.
33 services33 patients

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PARKSIDE PHARMACY INC
Pharmacy (Long Term Care Pharmacy)
2200 FERRY ST
LAFAYETTE, IN 47904
Tippecanoe County (765) 447-1000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Parkside Pharmacy Inc's NPI number?

The NPI number for Parkside Pharmacy Inc is 1063465904. It was assigned to this organization in the NPPES registry on May 19, 2006.

Where is Parkside Pharmacy Inc located?

Parkside Pharmacy Inc is located at 2200 Ferry St, Lafayette, IN 47904. The listed phone number is (765) 447-1000.

What is Parkside Pharmacy Inc's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Long Term Care Pharmacy, with taxonomy code 3336L0003X.

Is Parkside Pharmacy Inc enrolled in Medicare?

Yes. Parkside Pharmacy Inc is registered in the Medicare PECOS enrollment system.

When is Parkside Pharmacy Inc's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Indiana, Mass Immunization (Roster Biller Only)) is due for revalidation by March 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

What insurance does Parkside Pharmacy Inc accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter Health of Delaware, Ambetter from Absolute Total Care and Ambetter from Arkansas Health & Wellness and 41 other insurers list Parkside Pharmacy Inc as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Parkside Pharmacy Inc was last updated on August 15, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.