Organization
LAKEVIEW SPECIALTY PHARMACY INC
Active
Other names
Lakeview Specialty Pharmacy Inc
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT HARB (VP)
(248) 454-6500
Entity
Organization
Contact information
Practice address
21400 E 11 MILE RD, SAINT CLAIR SHORES, MI 48081-1502
(586) 777-4100
Mailing address
21400 E 11 MILE RD, SAINT CLAIR SHORES, MI 48081-1502
(586) 777-4100
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
5301009304
MI
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2373708
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
03/08/2010
Last updated
04/29/2010
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