Organization
LAKESIDE PHARMACY LLC
Active
Organization
LAKESIDE PHARMACY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MILAGRO BEATRIZ AMATO (OWNER)
(928) 846-8818
Entity
Organization
Contact information
Practice address
1960 MESQUITE AVE STE E, LAKE HAVASU CITY, AZ 86403-5783
(928) 846-8818
(928) 846-8817
Mailing address
1194 HILLSBORO MILE # E, HILLSBORO BEACH, FL 33062-1531
(954) 629-0324
(928) 846-8817
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
10/10/2017
Last updated
10/10/2017
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