Organization
EASTSIDE PHARMACY SERVICES, LLC
Active
Other names
Banner Drug of Troutman
Organization subpart
No
Provider details
NPI number
Authorized official
MELINDA C CHILDRESS (OWNER)
(704) 878-6681
Entity
Organization
Contact information
Practice address
106 WAGNER ST, TROUTMAN, NC 28166-9627
(704) 528-6611
Mailing address
3478 E BROAD ST, STATESVILLE, NC 28625-4523
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
07/02/2019
Last updated
07/02/2019
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