| NPI | 1437281847 |
|---|---|
| Doing Business As | LAKESIDE PHARMACY |
| Entity Type | Organization |
| Authorized Contact | APOLLON ANTHONY CONSTANTINIDES President 770-205-0290 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: GA 008517) |
| Enumeration Date | 2007-03-12 |
| Last Update Date | 2008-02-05 |