Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

South Park Pharmacy LLC

Organization Durable Medical Equipment & Medical Supplies · NPI 1922135763

South Park Pharmacy LLC is a Durable Medical Equipment & Medical Supplies in Lackawanna, New York. Licensed in New York. Registered with an NPI since 2007.

Licensed in
NY
In the registry since
2007
Specialties on file
3
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

2707 S Park Ave
Lackawanna, NY 14218-1511
Phone: (716) 823-0440
Fax: (716) 823-0444
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Community/Retail Pharmacy (primary) Taxonomy 3336C0003X · Licence 028253 (NY)
Durable Medical Equipment & Medical Supplies Taxonomy 332B00000X
Pharmacy Taxonomy 333600000X

Record details

NPI number1922135763
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Shawn Shelton — Owner/Pic/Ao · (716) 823-0440
Other names South Park Pharmacy
NPI enumeratedFebruary 28, 2007
Last updated in NPPESApril 21, 2017
Mailing address2707 S Park Ave, Lackawanna, NY 14218-1511

Other providers in Lackawanna