| NPI | 1164734927 |
|---|---|
| Doing Business As | LAKESIDE DISCOUNT PHARMACY |
| Entity Type | Organization |
| Authorized Contact | NAGESH SHAKHAMOORI Vice President 248-631-6612 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: FL PH24727) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2010-07-09 |
| Last Update Date | 2010-07-09 |