NPI age
13 years
Enumerated 2012-11-30
● Active Type 2 · Organization
Eastlake Pharmacy Inc
Eastlake Pharmacy Inc is 1 of 1965 pharmacy organizations in Georgia.
Primary specialty
Pharmacy
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Jusu
Owner Pharmacist-In-Charge
Last NPPES update
2012-11-30
Source: monthly bulk 2026-05
How this organization compares
Across 1965 active pharmacy providers in Georgia.
NPI age
13 years
↓ 6 yr below median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2012 → 2026
2012-11Enumerated in NPPES
2012
2026
Where they practice
Primary practice location
1308 Glenwood Ave Se
Atlanta, GA 303162077
Mailing address
4141 Brooks Mill Dr
Lithonia, GA 300384144
Authorized official
Thomas Jusu
Owner Pharmacist-In-Charge
📞 6783571044
Individual providers at this organization
1 individual provider on file at this primary practice address.
- Thomas Jusu, RPH Pharmacist NPI 1912475559
Specialties
-
Pharmacy PrimaryA pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 | 1163029 | NCPDP PROVIDER IDENTIFICATION NUMBER |
Other names on file (1)
Doing-business-as, former, and alternate names recorded by NPPES.
-
EASTLAKE PHARMACY
Practice context
Multi-provider organization. 1 individual provider on file at this primary address.
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