NPI | 1215189311 |
---|---|
Doing Business As | LAKESIDE FAMILY PHARMACY LLC |
Entity Type | Organization |
Authorized Contact | APOLLON CONSTANTINIDES Owner 770-781-1450 |
Organization Subpart ? | No |
Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: GA PHRE009517) |
Enumeration Date | 2008-10-21 |
Last Update Date | 2011-03-15 |