Eastside Pharmacy And Custom Compounding, Inc.

LBN: Eastside Pharmacy And Custom Compounding, Inc.
Eastside Pharmacy And Custom Compounding, Inc. is an health care organization with primary practice located at 1406 Lindsay Lane South Suite A, Athens AL 35613. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Eastside Pharmacy And Custom Compounding, Inc. can be contacted via phone (256) 233-7070, or through Cannon, Monique D. via phone (256) 233-7070.

Contact Information

Primary practice address
1406 Lindsay Lane South Suite A Athens AL 35613
Phone: (256) 233-7070
Fax: (256) 233-8891
Website:
Map and Directions
Authorized official contact:
Name: Cannon, Monique D. PHARMD
Phone: (256) 233-7070

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Suppliers / Community/Retail Pharmacy 3336C0003X 112977 Alabama

Profile Details

NPI number 1881884161
LBN Legal business name Eastside Pharmacy And Custom Compounding, Inc.
DBA Doing business as
Authorized official Cannon, Monique D. PHARMD
Entity Organization
Organization subpart 1 No
Enumeration date Aug 1st, 2007
Last updated Mar 23rd, 2021 - about 5 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1881884161 NPPES
Alabama MEDICAID 100039186

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