Organization
LAKESHORE PHARMACIES, INC.
Active
Other names
Allegan Community Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DANIEL MARK ALEXANDER R.PH. (PRESIDENT/PHARMACIST)
(269) 673-4188
Entity
Organization
Contact information
Practice address
115 LOCUST ST, ALLEGAN, MI 49010-1301
(269) 673-4188
(269) 673-6773
Mailing address
115 LOCUST ST, ALLEGAN, MI 49010-1301
(269) 673-4188
(269) 673-6773
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
5301005598
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0002808093
—
MI
05
—
2349694
—
MI
01
—
5301005598
STATE PHARMACY LICENSE #
MI
Enumeration date
08/08/2006
Last updated
08/22/2020
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