Organization
LAKEVIEW PHARMACY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY A GEHRKE RPH (PRESIDENT)
(715) 339-2424
Entity
Organization
Contact information
Practice address
114 N LAKE AVE, PHILLIPS, WI 54555-1221
(715) 339-2424
(715) 339-4027
Mailing address
114 N LAKE AVE, PHILLIPS, WI 54555-1221
(715) 339-2424
(715) 339-4027
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
5671042
WI
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33111000
—
WI
Enumeration date
08/14/2006
Last updated
02/10/2020
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