<Unavail>

LBN: Eastlake Pharmacy Inc
<Unavail> is an health care organization with primary practice located at 1308 Glenwood Ave Se , Atlanta GA 30316-2077. The organization recently has only one registered license in Suppliers / Community/Retail Pharmacy, which is considered as the primary health care specialty. Eastlake Pharmacy Inc can be contacted via phone (770) 593-8688, or through Jusu, Thomas via phone (678) 357-1044.

Contact Information

Primary practice address
1308 Glenwood Ave Se Atlanta GA 30316-2077
Phone: (770) 593-8688
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Jusu, Thomas
Phone: (678) 357-1044

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Community/Retail Pharmacy 3336C0003X PHRE009881 Georgia

Profile Details

NPI number 1255676326
LBN Legal business name Eastlake Pharmacy Inc
DBA Doing business as <Unavail>
Authorized official Jusu, Thomas
Entity Organization
Organization subpart 1 No
Enumeration date Nov 30th, 2012
Last updated Nov 30th, 2012 - about 14 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1255676326 NPPES
Other 1163029 NCPDP PROVIDER IDENTIFICATION NUMBER

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