Organization
TRUDAL, LLC
Active
Other names
Eastside Family Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MICHELE DUKE DALTON (OWNER)
(770) 807-0137
Entity
Organization
Contact information
Practice address
1795 PRESIDENTIAL CIR, SNELLVILLE, GA 30078-5644
(770) 807-0137
(770) 696-9374
Mailing address
3896 RIVERBANK DR SW, LILBURN, GA 30047-2587
(404) 642-8578
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHRE010050
GA
3336C0004X
Compounding Pharmacy
—
—
Other
Enumeration date
07/17/2014
Last updated
07/31/2014
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