Organization
LAKE CITY PHARMACY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANNE MARIE ANGE (PHARMACIST IN CHARGE/ MANAGING EMPL)
(586) 315-1200
Entity
Organization
Contact information
Practice address
33389 VAN DYKE AVE, STERLING HEIGHTS, MI 48312
(586) 315-1200
(866) 902-3981
Mailing address
33389 VAN DYKE AVE, STERLING HEIGHTS, MI 48312-5926
(586) 315-1200
(866) 902-3981
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
5301011132
MI
3336C0003X
Community/Retail Pharmacy
—
—
Other
Enumeration date
01/26/2017
Last updated
08/28/2018
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