Eastside Pharmacy Associates, LTD

Primary specialty

PharmacyTaxonomy code 333600000X

License

8942-042 Issued in WI

Legal business name

EASTSIDE PHARMACY ASSOCIATES, LTD

Practice address

4502 Monona Dr
Monona, WI 53716-1051

Phone

(608) 221-8151

Fax

(608) 221-4682

NPI assigned

Aug 31, 2006

Organization subpart

No

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

Authorized official

Name

Eric C Hewitt, PHARMD.NPI 1245337591

Title

Owner Pharmacist

Phone

(608) 221-8151

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Medicine Shoppe 0605,Ltd Doing business as

Medicare fee-for-service enrollment

Enrolled in WI

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.

• Eric Clinton Hewitt, PHARMD

  • Pharmacist
  • Madison, WI
  • NPI 1245337591
  NPD Authorized official
• Alison Elisabeth Beyler, PHARMD

  • Pharmacist
  • Madison, WI
  • NPI 1073556122
  NPD (past)

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1841302767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4205 MONONA DR",
            "city": "MONONA",
            "state": "WI",
            "postal_code": "537161663",
            "telephone_number": "608-221-8151",
            "fax_number": "608-221-4682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4502 MONONA DR",
            "city": "MONONA",
            "state": "WI",
            "postal_code": "537161051",
            "telephone_number": "608-221-8151",
            "fax_number": "608-221-4682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTSIDE PHARMACY ASSOCIATES, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "HEWITT",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER PHARMACIST",
        "authorized_official_telephone_number": "608-221-8151",
        "authorized_official_credential": "PHARMD."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "WI",
            "license": "8942-042",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "5117014",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33046300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medicine Shoppe 0605,Ltd",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kelly Jo Duprey, MA, LPC
• Reid Durtschi, M.S.
• Hallie Dybevik, OTR
• Megan Earhart, COUNSELOR
• Kayla Easland
• Arkeya T Echols
• Eclipse Counseling LLC
• Efficient Living LLC
• Carla Jean Eichinger, MSE
• Elkhart Psychological Services, LLC

• Pharmacy in Monona, WI
• Providers in Monona, WI by specialty
• Pharmacy in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.