Organization
LAKESIDE MEMORIAL HOSPITAL INC
Active
Other names
LAKESIDE MEMORIAL HOSP PHCY INC
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER DAILEY (DIRECTOR FO PHARMACY)
(585) 395-6043
Entity
Organization
Contact information
Practice address
156 WEST AVE, BROCKPORT, NY 14420-1229
(585) 395-6043
(585) 395-6022
Mailing address
156 WEST AVE, BROCKPORT, NY 14420-1229
(585) 395-6043
(585) 395-6022
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
—
—
3336I0012X
Institutional Pharmacy
Primary
012799
NY
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00279543
—
NY
01
—
3349037
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
06/14/2006
Last updated
01/07/2013
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