Eastside Pharmacy

LBN: Eastside Pharmacy Inc
Eastside Pharmacy is an health care organization with primary practice located at 11854 E Warren Ave , Detroit MI 48214-1664. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy, Suppliers / Compounding Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Eastside Pharmacy Inc can be contacted via phone (313) 579-1755, or through Khreizat, Sam via phone (313) 579-1755.

Contact Information

Primary practice address
11854 E Warren Ave Detroit MI 48214-1664
Phone: (313) 579-1755
Fax: (313) 579-2067
Website:
Map and Directions
Authorized official contact:
Name: Khreizat, Sam
Phone: (313) 579-1755

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X 5301009095 Michigan
Suppliers / Compounding Pharmacy 3336C0004X

Profile Details

NPI number 1720212681
LBN Legal business name Eastside Pharmacy Inc
DBA Doing business as Eastside Pharmacy
Authorized official Khreizat, Sam
Entity Organization
Organization subpart 1 No
Enumeration date May 7th, 2009
Last updated Nov 13th, 2014 - about 12 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 1720212681 NPPES
Other 2120128 PK

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