| NPI | 1780468884 |
|---|---|
| Doing Business As | LAKESIDE PHARMACY LLC |
| Entity Type | Organization |
| Authorized Contact | KIM HARRIGAN PREZIOSO Owner/PIC 936-448-6337 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy |
| Enumeration Date | 2023-08-21 |
| Last Update Date | 2023-08-21 |