Organization
EASTSIDE PHARMACY SERVICES LLC
Active
Other names
Banner Drug
Organization subpart
No
Provider details
NPI number
Authorized official
MELINDA C CHILDRESS PHARMD, MBA (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
183500000X
Pharmacist
Primary
17650
NC
Other
Enumeration date
09/08/2017
Last updated
08/28/2023
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