Organization
LAKESHORE PHARMACIES, INC
Active
Other names
Alexander's Drug Store
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DANIEL MARK ALEXANDER RPH. (PRESIDENT/CEO)
(269) 561-4411
Entity
Organization
Contact information
Practice address
211 EAST MAIN STREET, FENNVILLE, MI 49408
(269) 561-4411
(269) 561-5474
Mailing address
PO BOX 28, FENNVILLE, MI 49408
(269) 561-4411
(269) 561-5474
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
5301005615
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2349733
NCPDP
MI
01
—
2349733
NCPDP
—
05
—
2349733
—
MI
Enumeration date
08/09/2006
Last updated
07/17/2015
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