| NPI | 1841232147 |
|---|---|
| Doing Business As | EAST LAKE PHARMACY |
| Entity Type | Organization |
| Authorized Contact | G BRUCE THOMPSON Gm 540-587-0555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 333600000X Pharmacy (Licence: VA 0201004056) |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2025-09-11 |