| NPI | 1063416097 |
|---|---|
| Doing Business As | LAKEVIEW LTC PHARMACY |
| Entity Type | Organization |
| Authorized Contact | PETE CIARAMITA Owner 262-632-8215 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy (Licence: WI 7186-42) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2005-06-08 |
| Last Update Date | 2016-08-17 |