Organization
LAKESHORE APOTHACARE INC
Active
Other names
The Medicine Shoppe 1564 - LTC
Organization subpart
No
Provider details
NPI number
Authorized official
MARVIN ROBERT MOORE (PRESIDENT)
(920) 794-1225
Entity
Organization
Contact information
Practice address
1500 WASHINGTON ST, TWO RIVERS, WI 54241-3045
(920) 794-1225
Mailing address
1500 WASHINGTON ST, TWO RIVERS, WI 54241-3045
(920) 794-1225
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Enumeration date
11/25/2022
Last updated
11/25/2022
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