| NPI | 1447611280 |
|---|---|
| Doing Business As | LAKETOWN PHARMACY |
| Entity Type | Organization |
| Authorized Contact | MARK L DUVALL Governor/Owner 509-765-8891 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: WA 60642318) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2016-03-07 |
| Last Update Date | 2022-03-01 |