Organization
EASTERN STATES COMPOUNDING PHARMACY, LLC
Active
Other names
Eastern States Compounding Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
CLANCI GIDDINGS (GENERAL MANAGER)
(603) 444-0094
Entity
Organization
Contact information
Practice address
338 UNION ST, LITTLETON, NH 03561
(603) 444-0094
(603) 444-0095
Mailing address
338 UNION ST, LITTLETON, NH 03561
(603) 444-0094
(603) 444-0095
Taxonomy
Speciality
Code
Description
License number
State
3336C0004X
Compounding Pharmacy
Primary
0682
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3060782
NCPDP
—
Enumeration date
04/12/2007
Last updated
03/15/2022
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