Organization
EASTSIDE CLINIC PHARMACY
Active
Other names
EASTSIDE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
J BRENNAN (PARTNER PHARMACIST IN CHARGE)
(580) 355-6400
Entity
Organization
Contact information
Practice address
3612 SE LEE BLVD, LAWTON, OK 73501-8451
(580) 355-6400
(580) 355-0451
Mailing address
3612 SE LEE BLVD, LAWTON, OK 73501-8451
(580) 355-6400
(580) 355-0451
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
36455
OK
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100247000A
—
OK
01
—
2076429
PK
—
Enumeration date
07/22/2006
Last updated
06/07/2016
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us