NPIMap

Organization Active NPI

Vosmek Drug Store Inc

Doing business as Lakeside Pharmacy LTC

  • Long Term Care Pharmacy
  • Antigo, WI
National Provider Identifier
1306622964
Registry record updated Nov 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
Legal business name
VOSMEK DRUG STORE INC
Doing business as
Lakeside Pharmacy LTC
Practice address
536 5TH Ave
Antigo, WI 54409-2221
Phone
(715) 623-2631
Fax
(715) 623-6887
NPI assigned
Sep 7, 2023
Last updated
Nov 14, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2023

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

Authorized official

Name
Patrick William Frey, RPHNPI 1487735759
Title
President
Phone
(715) 623-2631

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Pharmacy 3336L0003X Primary

Addresses

Primary practice location

536 5TH Ave
Antigo, WI 54409-2221

Mailing address

536 5TH Ave
Antigo, WI 54409-2221
Phone (715) 623-2631

Other names 1

  • Lakeside Pharmacy LTC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Lakeside Pharmacy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1694044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699920000000",
    "number": "1306622964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "536 5TH AVE",
            "city": "ANTIGO",
            "state": "WI",
            "postal_code": "544092221",
            "telephone_number": "715-623-2631",
            "fax_number": "715-623-6887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "536 5TH AVE",
            "city": "ANTIGO",
            "state": "WI",
            "postal_code": "544092221",
            "telephone_number": "715-623-2631",
            "fax_number": "715-623-6887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VOSMEK DRUG STORE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-07",
        "last_updated": "2023-11-14",
        "certification_date": "2023-11-14",
        "status": "A",
        "authorized_official_last_name": "FREY",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "715-623-2631",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lakeside Pharmacy LTC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Antigo, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2023; 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.