Organization Active NPI

Lakeview Pharmacy of Racine Inc

  • Community/Retail Pharmacy
  • Racine, WI
National Provider Identifier
1154325199
Registry record updated Aug 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
7185-42 Issued in WI
Legal business name
LAKEVIEW PHARMACY OF RACINE INC
Practice address
516 Monument SQ
Racine, WI 53403-1033
Phone
(262) 632-0520
Fax
(262) 632-6777
NPI assigned
Jun 8, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Cheryl A Robotka
Title
Billing Manager
Phone
(262) 632-1830

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 7185-42 WI Primary
Compounding Pharmacy 3336C0004X

Addresses

Primary practice location

516 Monument SQ
Racine, WI 53403-1033

Mailing address

516 Monument SQ
Racine, WI 53403-1033
Phone (262) 632-0520

Other identifiers 2

IdentifierTypeStateIssuer
2114710OtherPK
33069400MedicaidWI

Other names 1

  • LAKEVIEW PHARMACY OF RACINE INC Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1118188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1566518400000",
    "number": "1154325199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "516 MONUMENT SQ",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534031033",
            "telephone_number": "262-632-0520",
            "fax_number": "262-632-6777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 MONUMENT SQ",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534031033",
            "telephone_number": "262-632-0520",
            "fax_number": "262-632-6777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKEVIEW PHARMACY OF RACINE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-08",
        "last_updated": "2019-08-23",
        "status": "A",
        "authorized_official_last_name": "ROBOTKA",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "262-632-1830"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WI",
            "license": "7185-42",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2114710",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33069400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LAKEVIEW PHARMACY OF RACINE INC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "LAKEVIEW PHARMACY OF RACINE INC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Racine, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.