Organization
EASTSIDE CLINIC PHARMACY
Active
Other names
Eastside Pharmacy LTC
Organization subpart
No
Provider details
NPI number
Authorized official
JESSE WILSON PHARMD (PIC/OWNER)
(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
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Enumeration date
05/23/2025
Last updated
05/23/2025
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