| NPI | 1295258200 |
|---|---|
| Doing Business As | LAKESHORE PHARMACY |
| Entity Type | Organization |
| Authorized Contact | CALEB JENSEMA COO 920-783-6633 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: WI 947242) |
| Additional Taxonomies | 3336C0002X Pharmacy, Clinic Pharmacy (Licence: WI 947242) |
| Enumeration Date | 2017-07-21 |
| Last Update Date | 2026-02-19 |