Eastside Pharmacy Services, LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

EASTSIDE PHARMACY SERVICES, LLC

Doing business as

Banner Drug Downtown Satatesville

Practice address

307 N Center St
Statesville, NC 28677-4063

Phone

(704) 872-0880

NPI assigned

Jul 2, 2019

Last updated

Aug 28, 2023By 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

Melinda C ChildressNPI 1609830025

Title

Pharmacist

Phone

(704) 878-6681

Specialties & licenses 1

Addresses

Other names 1

• Banner Drug Downtown Satatesville 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, and the practitioner matching its NPPES authorized official.

• Melinda C Childress, PHARMD, MBA

  • Pharmacist
  • Statesville, NC
  • NPI 1609830025
  Authorized official Same address or phone

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

{
    "created_epoch": "1562025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693180800000",
    "number": "1831751551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308A MOCKSVILLE HWY",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286258267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 N CENTER ST",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286774063",
            "telephone_number": "704-872-0880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTSIDE PHARMACY SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-02",
        "last_updated": "2023-08-28",
        "certification_date": "2023-08-28",
        "status": "A",
        "authorized_official_last_name": "CHILDRESS",
        "authorized_official_first_name": "MELINDA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "704-878-6681"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Banner Drug Downtown Satatesville",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Banner Drug Downtown Satatesville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Eastersealsucp-Asap Inc (Area Services and Programs Inc)
• Lee Hunter Easterwood, M.D.
• Eastside Pharmacy Services LLC (Banner Drug)
• Eastside Pharmacy Services LLC (Banner Drug Co)
• Eastside Pharmacy Services, LLC (Banner Drug LTC)
• Nicole Marie Eaton, PA-C
• Eckerd Corporation (Rite Aid Pharmacy 11547)
• Ida Lee Eden, MS, CCC-SLP
• Kristen Eden, PT, DPT
• Dominiquea Edmiston, LCSW

• Community/Retail Pharmacy in Statesville, NC
• Providers in Statesville, NC by specialty
• Community/Retail Pharmacy in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2023; 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.