OrganizationLakeshore Pharmacy, Inc.PharmacySuppliersPractice Address1 W Lakeshore Dr, Suite 102, Birmingham, AL 35209-0500(205) 945-8081PECOS EnrollmentBased on the most recent information from CMS, provider Lakeshore Pharmacy, Inc. does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 11:51 AM.Profile DetailsProvider ID1750425211Provider TypeOrganizationFull NameLakeshore Pharmacy, Inc.SubpartNoEnumeration Date2/17/2007Last Updated8/22/2020Contact InformationPractice LocationPractice Address1 W Lakeshore Dr, Suite 102, Birmingham, AL 35209-0500Phone(205) 945-8081Fax(205) 945-8508Mailing LocationMailing Address1 W Lakeshore Dr, Suite 102, Birmingham, AL 35209-0500Phone(205) 945-8081Fax(205) 945-8508Authorized OfficialNameBryant, Robert Ernest (President)Phone(205) 945-8081Provider TaxonomiesCodeDescriptionLicenseCode3336C0003XPrimaryDescriptionPharmacySuppliersLicense112213AlabamaProvider IdentifiersIDDescriptionIssuerID0125674DescriptionOtherIssuerNABPAlabama