| NPI | 1760534010 |
|---|---|
| Former Legal Business Name | WHITE OAK PHARMACY, INC. |
| Doing Business As | LEE GOODRUM EASTSIDE PHARMACY |
| Entity Type | Organization |
| Authorized Contact | TREY JOHN BERL THOMPSON Owner 404-969-9734 |
| Organization Subpart ? | No |
| Primary Taxonomy | 183500000X Pharmacist |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: GA 007093) |
| 3336C0004X Pharmacy, Compounding Pharmacy | |
| Enumeration Date | 2007-01-17 |
| Last Update Date | 2020-08-18 |