Eastside Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

5301007485 Issued in MI

Legal business name

EASTSIDE PHARMACY INC

Doing business as

Eastside Savmor Pharmacy

Practice address

11937 E Warren Ave
Detroit, MI 48214-1665

Phone

(313) 579-1755

Fax

(313) 579-2067

NPI assigned

Aug 27, 2006

Organization subpart

No

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

Authorized official

Name

Stephen Graham

Title

MGR Pharmacy Services

Phone

(248) 348-1570

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• EASTSIDE SAVMOR PHARMACY Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Hassan Subhi Abdallah, RPH

  • Pharmacist
  • Detroit, MI
  • NPI 1669594099
  NPD (past)

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

{
    "created_epoch": "1156636800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208217600000",
    "number": "1336257708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43155 W 9 MILE RD",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483754190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11937 E WARREN AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482141665",
            "telephone_number": "313-579-1755",
            "fax_number": "313-579-2067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTSIDE PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-27",
        "last_updated": "2008-04-15",
        "status": "A",
        "authorized_official_last_name": "GRAHAM",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_title_or_position": "MGR PHARMACY SERVICES",
        "authorized_official_telephone_number": "248-348-1570"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301007485",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER",
            "identifier": "2363428",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2363428",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EASTSIDE SAVMOR PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Marlen Thershia Easton, CADCM
• Matthew Easton
• Eastpointe Radiologists, P.C. (Grosse Pointe Physicians Xray Center, PC)
• Eastside Discount Pharmacy
• Eastside Neurosurgery PC
• Eastside Pharmacy Inc (Eastside Pharmacy)
• Eastwood Convalescent Center Inc. (Regency at Chene)
• Easy Ride
• Arnel Eatmon
• Isaiah Cary Eatmon, AA BUSINESS MANAGEME

• Community/Retail Pharmacy in Detroit, MI
• Providers in Detroit, MI by specialty
• Community/Retail Pharmacy in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2008; 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.