Organization
EASTSIDE PHARMACY ASSOCIATES, LTD
Active
Other names
Medicine Shoppe 0605,Ltd
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC C HEWITT PHARMD. (OWNER PHARMACIST)
(608) 221-8151
Entity
Organization
Contact information
Practice address
4502 MONONA DR, MONONA, WI 53716-1051
(608) 221-8151
(608) 221-4682
Mailing address
4205 MONONA DR, MONONA, WI 53716-1663
(608) 221-8151
(608) 221-4682
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
8942-042
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33046300
—
WI
01
—
5117014
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
08/31/2006
Last updated
03/07/2023
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