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Organization
LAKESIDE FAMILY PHARMACY LLC
Active
Organization
LAKESIDE FAMILY PHARMACY LLC
Active
Other names
Lakeside Family Pharmacy LLC
Organization subpart
No
Provider details
NPI number
Authorized official
APOLLON CONSTANTINIDES RPH (OWNER)
(770) 781-1450
Entity
Organization
Contact information
Practice address
1505 NORTHSIDE BLVD, STE 1600, CUMMING, GA 30041-7623
(770) 781-1450
(770) 781-1455
Mailing address
1505 NORTHSIDE BLVD, STE 1600, CUMMING, GA 30041-7623
(770) 781-1450
(770) 781-1455
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHRE009517
GA
Other
Enumeration date
10/21/2008
Last updated
03/15/2011
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