Organization
EASTSIDE PHARMACY SERVICES, LLC
Active
Other names
Banner Drug LTC
Organization subpart
No
Provider details
NPI number
Authorized official
MELINDA C CHILDRESS (OWNER)
(704) 878-6681
Entity
Organization
Contact information
Practice address
308A MOCKSVILLE HWY, STATESVILLE, NC 28625-8267
(704) 878-6681
Mailing address
308A MOCKSVILLE HWY, STATESVILLE, NC 28625-8267
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Enumeration date
01/19/2021
Last updated
08/22/2022
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