East Shore Pharmacy Inc.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PP481584 Issued in PA

Legal business name

EAST SHORE PHARMACY INC.

Practice address

2723 Agate St
Harrisburg, PA 17110-2645

Phone

(717) 213-3708

Fax

(717) 213-0095

NPI assigned

Aug 2, 2006

Last updated

Dec 11, 2017By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Andrew Mubbala, RPHNPI 1164682902

Title

Owner

Phone

(717) 213-3708

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Andrew Mubbala, RPH

  • Pharmacist
  • Plymouth Meeting, PA
  • NPI 1164682902
  NPD Authorized official
• Nana Mubbala

  • Pharmacist
  • Harrisburg, PA
  • NPI 1497596969
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1512950400000",
    "number": "1093722134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2723 AGATE ST",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171102645",
            "telephone_number": "717-213-3708",
            "fax_number": "717-213-0956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2723 AGATE ST",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171102645",
            "telephone_number": "717-213-3708",
            "fax_number": "717-213-0095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST SHORE PHARMACY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-02",
        "last_updated": "2017-12-11",
        "status": "A",
        "authorized_official_last_name": "MUBBALA",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "717-213-3708",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "PA",
            "license": "PP481584",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1017526390001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2088014",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James W Eash, MSW
• Melinda Margaret Eash, MS
• East End Medical Group
• East Shore Medical & Pain Management PC
• East Shore Oncology PC
• East Shore Psychiatric Associates PC
• East Shore Therapeutic Massage Center LLC
• Keri Tkatch Eastburn, DPT
• Easyudo Services LLC
• Easyudo Services LLC

• Community/Retail Pharmacy in Harrisburg, PA
• Providers in Harrisburg, PA by specialty
• Community/Retail Pharmacy in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.