East Side Pharmacy

LBN: Eastside Pharmacy, Inc.
East Side Pharmacy is an health care organization with primary practice located at 400 E Pine St , Poplar Bluff MO 63901-5401. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Community/Retail Pharmacy, Suppliers / Long Term Care Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Eastside Pharmacy, Inc. can be contacted via phone (573) 686-7238, or through Rowland, Stephen Kennedy via phone (573) 686-7238.

Contact Information

Primary practice address
400 E Pine St Poplar Bluff MO 63901-5401
Phone: (573) 686-7238
Fax: (573) 686-7239
Website:
Map and Directions
Authorized official contact:
Name: Rowland, Stephen Kennedy RPH
Phone: (573) 686-7238

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Suppliers / Community/Retail Pharmacy 3336C0003X 005573 Missouri
Suppliers / Long Term Care Pharmacy 3336L0003X 005573 Missouri

Profile Details

NPI number 1750421079
LBN Legal business name Eastside Pharmacy, Inc.
DBA Doing business as East Side Pharmacy
Authorized official Rowland, Stephen Kennedy RPH
Entity Organization
Organization subpart 1 No
Enumeration date Feb 7th, 2007
Last updated Mar 26th, 2024 - about 6 months 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 1750421079 NPPES
Missouri MEDICAID 601773500

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