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Organization
LAKEVIEW PHARMACY OF RACINE INC
Active
Organization
LAKEVIEW PHARMACY OF RACINE INC
Active
Other names
LAKEVIEW PHARMACY OF RACINE INC
Organization subpart
No
Provider details
NPI number
Authorized official
CHERYL A ROBOTKA (BILLING MANAGER)
(262) 632-1830
Entity
Organization
Contact information
Practice address
516 MONUMENT SQ, RACINE, WI 53403-1033
(262) 632-0520
(262) 632-6777
Mailing address
516 MONUMENT SQ, RACINE, WI 53403-1033
(262) 632-0520
(262) 632-6777
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
7185-42
WI
3336C0004X
Compounding Pharmacy
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2114710
PK
—
05
—
33069400
—
WI
Enumeration date
06/08/2005
Last updated
08/23/2019
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