East Side Prescription Center Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

209 Issued in RI

Legal business name

EAST SIDE PRESCRIPTION CENTER INC

Practice address

632 Hope St
Providence, RI 02906-2658

Phone

(401) 751-1430

Fax

(401) 454-8096

NPI assigned

Jun 19, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Richard E Backer, R.PH.

Title

Pres

Phone

(401) 751-1430

Specialties & licenses 2

Addresses

Other identifiers 3

Locations

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

{
    "created_epoch": "1150675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1232409600000",
    "number": "1194760470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "632 HOPE ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029062658",
            "telephone_number": "401-751-1430",
            "fax_number": "401-454-8096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "632 HOPE ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029062658",
            "telephone_number": "401-751-1430",
            "fax_number": "401-454-8096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST SIDE PRESCRIPTION CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-19",
        "last_updated": "2009-01-20",
        "status": "A",
        "authorized_official_last_name": "BACKER",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRES",
        "authorized_official_telephone_number": "401-751-1430",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "R.PH."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "RI",
            "license": "ES04467",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "RI",
            "license": "209",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ES04467",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "4102961",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9010209",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary-Kate P Earley, PMHNP-BC
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• East Side Endodontics
• East Side Orthopaedics, Inc
• East Side Primary Care Providence LLC
• East Side Psychiatric Associates, LTD
• East Side Psychotherapy, Inc.
• East Side Psychotherapy, Inc.
• East Side Urgent Care LLC

• Community/Retail Pharmacy in Providence, RI
• Providers in Providence, RI by specialty
• Community/Retail Pharmacy in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.