Organization
LAKEWAY PHARMACY
Active
Other names
LAKEWAY PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
KEITH ALLEMAN PHRMD (MANG)
(865) 406-4942
Entity
Organization
Contact information
Practice address
460 MEDICAL PARK DR, STE 101, LENOIR CITY, TN 37772-5782
(865) 988-9858
(865) 988-9859
Mailing address
460 MEDICAL PARK DR, STE 101, LENOIR CITY, TN 37772-5782
(865) 988-9858
(865) 988-9859
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
4433
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4440690
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
10/12/2007
Last updated
05/04/2010
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