Organization
EAST LAKE PHARMACY
Active
Organization
EAST LAKE PHARMACY
Active
Other names
EAST LAKE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
RUDY SMITH (OWNER)
(214) 327-7334
Entity
Organization
Contact information
Practice address
10611 GARLAND RD, STE 104, DALLAS, TX 75218-2666
(214) 327-7334
(214) 327-7335
Mailing address
10611 GARLAND RD, STE 104, DALLAS, TX 75218-2666
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
06381
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4544640
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
10/24/2007
Last updated
11/19/2008
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up