| NPI | 1912497496 |
|---|---|
| Doing Business As | LAKESIDE SPECIALTY PHARMACY |
| Entity Type | Organization |
| Authorized Contact | ANKIT J PATEL Pharmacy Manger/Owner 704-360-2029 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2018-05-10 |
| Last Update Date | 2020-12-01 |