Organization
LIVONIA LAKEVILLE PHARMACY INC
Active
Other names
LIVONIA PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER BURKE (VICE PRESIDENT)
(585) 346-5615
Entity
Organization
Contact information
Practice address
5975 BIG TREE RD, LAKEVILLE, NY 14480-0414
(585) 346-5615
(585) 346-2212
Mailing address
PO BOX 414, LAKEVILLE, NY 14480-0414
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
024333
NY
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1944178
—
NY
01
—
2064266
PK
—
Enumeration date
12/15/2006
Last updated
06/20/2013
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