Eastside Pharmacy

LBN: Eastside Clinic Pharmacy
Eastside Pharmacy is an health care organization with primary practice located at 3612 Se Lee Blvd , Lawton OK 73501-8451. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Community/Retail Pharmacy, Suppliers / Long Term Care Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Eastside Clinic Pharmacy can be contacted via phone (580) 355-6400, or through Brennan, J via phone (580) 355-6400.

Contact Information

Primary practice address
3612 Se Lee Blvd Lawton OK 73501-8451
Phone: (580) 355-6400
Fax: (580) 355-0451
Website:
Map and Directions
Authorized official contact:
Name: Brennan, J
Phone: (580) 355-6400

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Community/Retail Pharmacy 3336C0003X 36455 Oklahoma
Suppliers / Long Term Care Pharmacy 3336L0003X

Profile Details

NPI number 1215958285
LBN Legal business name Eastside Clinic Pharmacy
DBA Doing business as Eastside Pharmacy
Authorized official Brennan, J
Entity Organization
Organization subpart 1 No
Enumeration date Jul 22nd, 2006
Last updated Jun 7th, 2016 - about 10 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 1215958285 NPPES
Oklahoma MEDICAID 100247000A
Oklahoma Other 2076429

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