Eastern States Compounding Pharmacy, LLC

Primary specialty

Compounding PharmacyTaxonomy code 3336C0004X

License

0682 Issued in NH

Legal business name

EASTERN STATES COMPOUNDING PHARMACY, LLC

Practice address

338 Union St
Littleton, NH 03561

Phone

(603) 444-0094

Fax

(603) 444-0095

NPI assigned

Apr 12, 2007

Organization subpart

No

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

Authorized official

Name

Clanci Giddings

Title

General Manager

Phone

(603) 444-0094

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Eastern States Compounding Pharmacy Doing business as

Tax ID family

Eastern States Compounding Pharmacy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Northern New England Compounding Pharmacy

  • Compounding Pharmacy
  • Littleton, NH
  • NPI 1568657740
  NPD tax ID

Locations

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647302400000",
    "number": "1932323136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "338 UNION ST",
            "city": "LITTLETON",
            "state": "NH",
            "postal_code": "03561",
            "telephone_number": "603-444-0094",
            "fax_number": "603-444-0095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "338 UNION ST",
            "city": "LITTLETON",
            "state": "NH",
            "postal_code": "03561",
            "telephone_number": "603-444-0094",
            "fax_number": "603-444-0095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTERN STATES COMPOUNDING PHARMACY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-12",
        "last_updated": "2022-03-15",
        "certification_date": "2022-03-15",
        "status": "A",
        "authorized_official_last_name": "GIDDINGS",
        "authorized_official_first_name": "CLANCI",
        "authorized_official_title_or_position": "GENERAL MANAGER",
        "authorized_official_telephone_number": "603-444-0094"
    },
    "taxonomies": [
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "NH",
            "license": "0682",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "3060782",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eastern States Compounding Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Dooryardnp, LLC
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• William R Dufresne
• Emily Dupont, RN CDCES
• Eastern States Compounding Pharmacy, LLC
• Elizabeth Pearson
• Cori L Elliott, APRN-FNP
• Bonnie F Ellis, PT
• Stephanie Emery
• Envision Eye Care, PLLC

• Compounding Pharmacy in Littleton, NH
• Providers in Littleton, NH by specialty
• Compounding Pharmacy in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2022; 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.