| NPI | 1376577023 |
|---|---|
| Doing Business As | NORTH LAKE MEDICAL PHARMACY #2 |
| Entity Type | Organization |
| Authorized Contact | ROBERT DANIEL NEELEY Owner 707-263-1326 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: CA PHY412710) |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2020-04-01 |