Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Eastlake Pharmacy Inc

Organization Community/Retail Pharmacy · NPI 1255676326

Eastlake Pharmacy Inc is a Community/Retail Pharmacy in Atlanta, Georgia. Licensed in Georgia. Registered with an NPI since 2012.

Licensed in
GA
In the registry since
2012
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1308 Glenwood Ave SE
Atlanta, GA 30316-2077
Phone: (770) 593-8688
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Community/Retail Pharmacy (primary) Taxonomy 3336C0003X · Licence PHRE009881 (GA)

Record details

NPI number1255676326
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Thomas Jusu — Owner Pharmacist-In-Charge · (678) 357-1044
Other names Eastlake Pharmacy
NPI enumeratedNovember 30, 2012
Last updated in NPPESNovember 30, 2012
Mailing address4141 Brooks Mill Dr, Lithonia, GA 30038-4144

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