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
—
—
3336C0003X
Community/Retail Pharmacy
Primary
7185-42
WI
3336C0004X
Compounding Pharmacy
—
—
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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