| NPI | 1427841360 |
|---|---|
| Doing Business As | EASTSIDE PHARMACY LTC |
| Entity Type | Organization |
| Authorized Contact | JESSE WILSON PIC/Owner 580-355-6400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy |
| Enumeration Date | 2025-05-23 |
| Last Update Date | 2025-05-23 |