| NPI | 1487322780 |
|---|---|
| Doing Business As | LAKESIDE PHARMACY |
| Entity Type | Organization |
| Authorized Contact | STANLEY JON LEONG CFO 916-747-5094 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2021-09-01 |
| Last Update Date | 2021-09-01 |