| NPI | 1588896245 |
|---|---|
| Doing Business As | NORTHLAKE PHARMACY |
| Entity Type | Organization |
| Authorized Contact | MICHAEL CHAMBERLAIN President/P.I.C. 985-327-0594 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: LA PHY006184IR) |
| Additional Taxonomies | 3336C0004X Pharmacy, Compounding Pharmacy |
| Enumeration Date | 2009-08-13 |
| Last Update Date | 2011-02-10 |