| NPI | 1255676326 |
|---|---|
| Doing Business As | EASTLAKE PHARMACY |
| Entity Type | Organization |
| Authorized Contact | THOMAS JUSU Owner Pharmacist In Charge 678-357-1044 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: GA PHRE009881) |
| Enumeration Date | 2012-11-30 |
| Last Update Date | 2012-11-30 |