Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Organization
LAKESHORE APOTHACARE INC
Active
Organization
LAKESHORE APOTHACARE INC
Active
Other names
MEDICINE SHOPPE
Organization subpart
No
Provider details
NPI number
Authorized official
DENA FERMAN (THIRD PARTY PLAN COORDINATOR)
(314) 993-6000
Entity
Organization
Contact information
Practice address
2219 GARFIELD ST, TWO RIVERS, WI 54241-2416
(920) 793-2927
(920) 794-8783
Mailing address
2219 GARFIELD ST, TWO RIVERS, WI 54241-2416
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
7221
WI
3336C0003X
Community/Retail Pharmacy
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33185800
—
WI
01
—
5121087
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
09/06/2006
Last updated
03/07/2023
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign upProduct
Developers