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LAKE O RX
NPI 1831608108
Pharmacy - Community/Retail Pharmacy in Lake Odessa, MI

Active since September 29, 2017CLIA 23D2182455 · Waiver
802 4TH AVE, LAKE ODESSA, MI 48849(877) 855-9777(877) 855-8222 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 21, 2022, Oct 30, 2020 (2 updates tracked since 2020).

About Lake O Rx NPPES

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

LAKE O RX (NPI 1831608108) is a healthcare organization registered as a community/retail pharmacy in Lake Odessa, Michigan and active in the NPI registry since September 2017. The organization holds a CLIA Waiver certificate valid through April 21, 2028 and lists Andrea Cusack, Owner/pharmacist, as its authorized official.

NPPES Registry Identity

NPI1831608108
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameLAKE ODESSA PHARMACY
Location Address802 4TH AVELake Odessa, MI 48849-1002
Mailing Address802 4th AveLake Odessa, MI 48849-1002 · (877) 855-9777 · Fax (877) 855-8222
Phone(877) 855-9777
Fax(877) 855-8222
Organization SubpartNo
Authorized OfficialAndrea CusackOwner/pharmacist · (877) 855-9777
Enumeration DateSeptember 29, 2017
Last NPPES UpdateJuly 21, 20222 updates tracked since enumeration
NPPES CertifiedOctober 30, 2020
✔ NPI 1831608108 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
License✔ Licensed in MI · 5301011266
Definition
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.
802 4TH AVE, Lake Odessa, MI 48849
Open in Google Maps ↗

Other Names 1

Doing Business AsLake O Rx

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 Arizona Complete Health and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 23D2182455

Lake Odessa Pharmacy · Lake Odessa, MI
Active · expires Apr 21, 2028
CLIA Number23D2182455
Laboratory TypePharmacy
Certificate Effective DateApril 22, 2026
Certificate Expiration DateApril 21, 2028
Laboratory DirectorAndrea R. Cusack
Laboratory Phone(877) 855-9777
Laboratory LocationLake Odessa Pharmacy802 4th Avenue, Lake Odessa, MI 48849
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 3

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.
38 services38 patients
Influenza vaccine split virus, preservative free 90662
The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.
26 services26 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.
11 services11 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.

ANDREA R CUSACK
Pharmacist
802 4TH AVE
LAKE ODESSA, MI 48849
Ionia County (877) 855-9777

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 Lake Odessa Pharmacy's NPI number?

The NPI number for Lake Odessa Pharmacy is 1831608108. It was assigned to this organization in the NPPES registry on September 29, 2017. The provider is doing business as Lake O Rx.

Where is Lake Odessa Pharmacy located?

Lake Odessa Pharmacy is located at 802 4th Ave, Lake Odessa, MI 48849. The listed phone number is (877) 855-9777.

What is Lake Odessa Pharmacy's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.

Does Lake Odessa Pharmacy hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 23D2182455) is associated with this NPI, valid through April 21, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Lake Odessa Pharmacy accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter Health of Delaware, Ambetter from Absolute Total Care and Ambetter from Arizona Complete Health and 51 other insurers list Lake Odessa Pharmacy 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 Lake Odessa Pharmacy was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.