| NPI | 1386174894 |
|---|---|
| Doing Business As | LAKEFOREST PHARMACY |
| Entity Type | Organization |
| Authorized Contact | THOMAS WEGRZYN Owner 636-856-9555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: MO 2017018401) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2017-06-16 |
| Last Update Date | 2019-12-08 |