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Organization
NORTHLAKE PHARMACY INC
Active
Organization
NORTHLAKE PHARMACY INC
Active
Other names
Northlake Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL CHAMBERLAIN (PRESIDENT/P.I.C.)
(985) 327-0594
Entity
Organization
Contact information
Practice address
7047 HIGHWAY 190 EAST SERVICE RD, EAST SERVICE ROAD, COVINGTON, LA 70433-4955
(985) 327-0594
(985) 327-0597
Mailing address
7047 HIGHWAY 190 EAST SERVICE RD, EAST SERVICE ROAD, COVINGTON, LA 70433-4955
(985) 327-0594
(985) 327-0597
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHY006184IR
LA
3336C0004X
Compounding Pharmacy
—
NULL
Other
Enumeration date
08/13/2009
Last updated
02/10/2011
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