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Organization

LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION, INC

Active
Other names
Lakeview Homecare Pharmacy
Organization subpart
No

Provider details

NPI number
Authorized official
DOUGLAS EDWARD JOHNSON (CFO)
(651) 430-4581
Entity
Organization

Contact information

Practice address
927 CHURCHILL ST W, STILLWATER, MN 55082-6605
(651) 430-4562
(651) 430-8540
Mailing address
927 CHURCHILL ST W, STILLWATER, MN 55082-6605
(651) 430-4562
(651) 430-8540

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
3336H0001X
Home Infusion Therapy Pharmacy
Primary
261233-1
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2424581
NABP NUMBER
MN
Enumeration date
10/31/2006
Last updated
09/13/2011
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