| NPI | 1245723725 |
|---|---|
| Doing Business As | LAKESIDE PHARMACY |
| Entity Type | Organization |
| Authorized Contact | THANVEER REDDY GADWAL Manager 980-441-8600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: NC 13756) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2018-06-11 |
| Last Update Date | 2020-09-24 |