# LAKEVIEW PHARMACY INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1487667903
- **Authorized official:** TIMOTHY A GEHRKE RPH (PRESIDENT)
- **Authorized official phone:** (715) 339-2424

## Contact information

- **Practice address:** 114 N LAKE AVE, PHILLIPS, WI 54555-1221
- **Practice address phone:** (715) 339-2424
- **Practice address fax:** (715) 339-4027
- **Mailing address:** 114 N LAKE AVE, PHILLIPS, WI 54555-1221
- **Mailing address phone:** (715) 339-2424
- **Mailing address fax:** (715) 339-4027

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | 5671042 | WI | Yes |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 08/14/2006
- **Last updated:** 02/10/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 33111000 | — | WI |