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Organization
EASTERN STATES COMPOUNDING PHARMACY, LLC
Active
Organization
EASTERN STATES COMPOUNDING PHARMACY, LLC
Active
Other names
Eastern States Compounding Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
CLANCI GIDDINGS (GENERAL MANAGER)
(603) 444-0094
Entity
Organization
Contact information
Practice address
338 UNION ST, LITTLETON, NH 03561
(603) 444-0094
(603) 444-0095
Mailing address
338 UNION ST, LITTLETON, NH 03561
(603) 444-0094
(603) 444-0095
Taxonomy
Speciality
Code
Description
License number
State
3336C0004X
Compounding Pharmacy
Primary
0682
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3060782
NCPDP
—
Enumeration date
04/12/2007
Last updated
03/15/2022
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