NPI | 1164839577 |
---|---|
Doing Business As | EASTSIDE FAMILY PHARMACY |
Entity Type | Organization |
Authorized Contact | MICHELE DUKE DALTON Owner 770-807-0137 |
Organization Subpart ? | No |
Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: GA PHRE010050) |
Additional Taxonomies | 3336C0004X Pharmacy, Compounding Pharmacy |
Enumeration Date | 2014-07-17 |
Last Update Date | 2014-07-31 |