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SOUTH PARK PHARMACY
NPI 1922135763
Pharmacy - Community/Retail Pharmacy in Lackawanna, NY

Active since February 28, 2007
2707 S PARK AVE, LACKAWANNA, NY 14218(716) 823-0440(716) 823-0444 Get Directions Write a Review

NPPES record last updated: April 21, 2017. Verified against the NPPES registry weekly; last sync: August 30, 2026.

Record update history: Apr 21, 2017, Jul 14, 2016 (2 updates tracked since 2016).

About South Park Pharmacy NPPES

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

SOUTH PARK PHARMACY (NPI 1922135763) is a healthcare organization registered as a community/retail pharmacy in Lackawanna, New York and active in the NPI registry since February 2007. The organization lists Shawn Shelton, Owner/pic/ao, as its authorized official.

NPPES Registry Identity

NPI1922135763
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameSOUTH PARK PHARMACY LLC
Location Address2707 S PARK AVELackawanna, NY 14218-1511
Mailing Address2707 S Park AveLackawanna, NY 14218-1511 · (716) 823-0440 · Fax (716) 823-0444
Phone(716) 823-0440
Fax(716) 823-0444
Organization SubpartNo
Authorized OfficialShawn SheltonOwner/pic/ao · (716) 823-0440
Enumeration DateFebruary 28, 2007
Last NPPES UpdateApril 21, 20172 updates tracked since enumeration
✔ NPI 1922135763 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
License✔ Licensed in NY · 028253
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.
Also ListedDurable Medical Equipment & Medical SuppliesTaxonomy 332B00000X
Also ListedPharmacyTaxonomy 333600000X
2707 S PARK AVE, Lackawanna, NY 14218
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Other Names 1

Doing Business AsSouth Park Pharmacy

Other Identifiers 3

Medicare NSC5957620001
Medicaid02885981NY
Other2068947Pk

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Medica.Insurance ›

Other Providers at the Same Location NPPES

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

DR. JOHN ACEVSKI PHARMD
Pharmacist
2707 S PARK AVE
LACKAWANNA, NY 14218
Erie County (716) 823-0440

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 South Park Pharmacy LLC's NPI number?

The NPI number for South Park Pharmacy LLC is 1922135763. It was assigned to this organization in the NPPES registry on February 28, 2007. The provider is doing business as South Park Pharmacy.

Where is South Park Pharmacy LLC located?

South Park Pharmacy LLC is located at 2707 S Park Ave, Lackawanna, NY 14218. The listed phone number is (716) 823-0440.

What is South Park Pharmacy LLC's specialty?

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

What insurance does South Park Pharmacy LLC accept?

Health plans from Medica list South Park Pharmacy LLC 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 South Park Pharmacy LLC was last updated on April 21, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.