Organization
LAKEVIEW MEMORIAL HOSPITAL ASSN, INC
Active
Other names
Lakeview Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DOUGLAS EDWARD JOHNSON (CFO)
(651) 430-4581
Entity
Organization
Contact information
Practice address
927 CHURCHILL ST W, STILLWATER, MN 55082-6605
(651) 430-4562
(651) 430-8540
Mailing address
927 CHURCHILL ST W, STILLWATER, MN 55082-6605
(651) 439-5330
(651) 430-8540
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
200202-2
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
194023600
—
MN
01
—
241225-7
NABP NUMBER
MN
05
—
33218600
—
WI
Enumeration date
10/31/2006
Last updated
05/09/2008
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