| NPI | 1831204940 |
|---|---|
| Doing Business As | ESSENTIA HEALTH LAKESIDE PHARMACY |
| Entity Type | Organization |
| Authorized Contact | KEVIN BOREN VP Of Finance 218-786-1009 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: MN 2612425) |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2024-02-28 |