Organization
LAKESIDE PHARMACY LLC
Active
Other names
LAKESIDE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
CHERYL CATTANEO (PHARMACIST-IN-CHARGE/MANAGER)
(406) 844-0777
Entity
Organization
Contact information
Practice address
7100 HWY 93 SOUTH, SUITE A, LAKESIDE, MT 59922
(406) 844-0777
(406) 844-0776
Mailing address
PO BOX 459, LAKESIDE, MT 59922-0459
(406) 844-0777
(406) 844-0776
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
1326
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2783721
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
02/18/2011
Last updated
03/17/2011
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