| NPI | 1558078634 |
|---|---|
| Doing Business As | EASTLAKE PHARMACY |
| Entity Type | Organization |
| Authorized Contact | SAMUEL O MELFAH CEO/Owner 915-408-3475 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 333600000X Pharmacy | |
| Enumeration Date | 2022-10-31 |
| Last Update Date | 2023-07-01 |