EASTSIDE PHARMACY SERVICES LLC NPI 1134719628

NPI Information

  • NPI: 1134719628
  • Provider Name: EASTSIDE PHARMACY SERVICES, LLC
  • Classification: Pharmacy - 3336L0003X
  • Specialization: Long Term Care Pharmacy
  • Entity Type: Organization
  • Doing Business As: BANNER DRUG LTC
  • Address: 308A MOCKSVILLE HWY
    STATESVILLE, NC
    ZIP 28625
  • Phone: (704) 878-6681

Map and Directions

Get Directions

NPI Details

EASTSIDE PHARMACY SERVICES, LLC is a long term care pharmacy pharmacy in Statesville, NC. The provider is a pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements. EASTSIDE PHARMACY SERVICES, LLC NPI is 1134719628. The provider is registered as an organization entity type.
The provider Is Doing Business As Banner Drug Ltc.

The provider's business location address is:

308A MOCKSVILLE HWY
STATESVILLE, NC
ZIP 28625-267
Phone: (704) 878-6681

The provider's authorized official is Melinda C Childress .
The authorized official title is Owner and has the following contact phone number (704) 878-6681.

The enumeration date for this NPI number is 1/19/2021 and was last updated on 8/22/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
13336L0003XPharmacyLong Term Care PharmacyYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

Previous NPI
Next NPI