Active NPI
Lakeview Pharmacy of Racine Inc
- Community/Retail Pharmacy
- Racine, WI
National Provider Identifier
1154325199
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- 7185-42
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2114710 | Other | PK | |
| 33069400 | Medicaid | WI |
Other names 1
- LAKEVIEW PHARMACY OF RACINE INC
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Pharmacist
- Racine, WI
- NPI 1114060365
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.