| NPI | 1346285707 |
|---|---|
| Doing Business As | LAKESIDE PHARMACY |
| Entity Type | Organization |
| Authorized Contact | PATRICK WILLIAM FREY President 715-623-2631 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: WI 7813042) |
| Enumeration Date | 2006-06-19 |
| Last Update Date | 2011-12-05 |