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General NPI Number Information
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NPI Number | 1962412817
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Entity Type | Organization
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Legal Business Name | LAKESHORE PHARMACIES, INC.
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Dates
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Enumeration Date | 08/09/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 201 BUTLER ST.
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City | SAUGATUCK
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State | MI
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Zip | 49453
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Country | US
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Telephone | 269-857-2300
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Fax | 269-857-1874
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Provider Business Mailing Address
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Address Line | 201 BUTLER ST. PO BOX 188
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City | SAUGATUCK
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State | MI
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Zip | 49453
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Country | US
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Telephone | 269-857-2300
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Fax | 269-857-1874
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. DANIEL MARK ALEXANDER
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Credential | PHARMACIST
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Telephone | 269-857-2300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 5301005599
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License Number State | MI
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