# VOSMEK DRUG STORE INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Lakeside Pharmacy LTC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1306622964
- **Authorized official:** PATRICK WILLIAM FREY RPH (PRESIDENT)
- **Authorized official phone:** (715) 623-2631

## Contact information

- **Practice address:** 536 5TH AVE, ANTIGO, WI 54409-2221
- **Practice address phone:** (715) 623-2631
- **Practice address fax:** (715) 623-6887
- **Mailing address:** 536 5TH AVE, ANTIGO, WI 54409-2221
- **Mailing address phone:** (715) 623-2631
- **Mailing address fax:** (715) 623-6887

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 09/07/2023
- **Last updated:** 11/14/2023