Organization
VOSMEK DRUG STORE INC
Active
Other names
LAKESIDE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PATRICK WILLIAM FREY RPH (PRESIDENT)
(715) 623-2631
Entity
Organization
Contact information
Practice address
536 5TH AVE, ANTIGO, WI 54409-2221
(715) 623-2631
(715) 623-6887
Mailing address
536 5TH AVE, ANTIGO, WI 54409-2221
(715) 623-2631
(715) 623-6887
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
7813042
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33082400
—
WI
Enumeration date
06/19/2006
Last updated
12/05/2011
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