Provider Demographics
NPI:1063765634
Name:LCS-WESTMINSTER NEWCASTLE LLC
Entity type:Organization
Organization Name:LCS-WESTMINSTER NEWCASTLE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PHARMACY
Authorized Official - Prefix:
Authorized Official - First Name:JUDITH
Authorized Official - Middle Name:
Authorized Official - Last Name:LINTNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:262-387-8888
Mailing Address - Street 1:12600 N PORT WASHINGTON RD
Mailing Address - Street 2:
Mailing Address - City:MEQUON
Mailing Address - State:WI
Mailing Address - Zip Code:53092-3469
Mailing Address - Country:US
Mailing Address - Phone:262-387-8888
Mailing Address - Fax:262-387-8829
Practice Address - Street 1:12600 N PORT WASHINGTON RD
Practice Address - Street 2:
Practice Address - City:MEQUON
Practice Address - State:WI
Practice Address - Zip Code:53092-3469
Practice Address - Country:US
Practice Address - Phone:262-387-8888
Practice Address - Fax:262-387-8829
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-19
Last Update Date:2013-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI9164-423336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
5133549OtherNCPDP PROVIDER IDENTIFICATION NUMBER