Organization · NPI-2

Lakevick LLC

Clinic/Center · Doylestown, PA

NPI number1730611419
StatusActive
Last updated in NPPESNov 20, 2024

Details

NPI
1730611419
Entity type
Organization (NPI-2)
Legal business name
Lakevick LLC
Organization subpart
No
Enumeration date
Mar 31, 2017
Certification date
Nov 20, 2024
Last updated
Nov 20, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261Q00000X Clinic/CenterOS007466LPAYes
183500000X PharmacistRPI000001PA
261Q00000X Clinic/Center––
261QH0100X Clinic/Center, Health ServicesOS007466LPA

Other names

  • Vickery Vaccine Services (Doing Business As)

Practice location

1980 S Easton Rd
Doylestown, PA 18901-7103

Phone 267-640-6733 · Fax 267-483-8795

Mailing address

50 Kulp Rd E
Chalfont, PA 18914-3729

Phone 267-640-6733 · Fax 267-483-8795

Other practice locations

50 Kulp Rd E
Chalfont, PA 18914-3729

Phone 267-477-1010 · Fax 215-491-5519

Authorized official

James H Vickery
Owner/Pharmacist
2153489711

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