Organization
LAKESHORE PHARMACY INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PATTY GREGORY GUINN PHARM.D. (PRESIDENT)
(606) 561-7104
Entity
Organization
Contact information
Practice address
51 W LAKESHORE DR, BURNSIDE, KY 42519-9424
(606) 561-7104
(606) 561-9205
Mailing address
51 W LAKESHORE DR, BURNSIDE, KY 42519-9424
(606) 561-7104
(606) 561-9205
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
P06673
KY
332B00000X
Durable Medical Equipment & Medical Supplies
P06673
KY
3336C0003X
Community/Retail Pharmacy
Primary
P06673
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1826962
NABP
KY
05
—
54002555
—
KY
05
—
90003427
—
KY
Enumeration date
07/01/2006
Last updated
09/17/2008
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