BANNER DRUG LTC
NPI 1134719628
Pharmacy - Long Term Care Pharmacy in Statesville, NC
About Banner Drug Ltc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
BANNER DRUG LTC (NPI 1134719628) is a healthcare organization registered as a long term care pharmacy in Statesville, North Carolina and active in the NPI registry since January 2021. The organization holds a CLIA Waiver certificate valid through August 13, 2027 and lists Melinda C Childress, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Accepted Insurance
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 34D2135031
Eastside Pharmacy Services Dba Banner Drug · Statesville, NCOther Providers at the Same Location NPPES 3
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Eastside Pharmacy Services, LLC's NPI number?
The NPI number for Eastside Pharmacy Services, LLC is 1134719628. It was assigned to this organization in the NPPES registry on January 19, 2021. The provider is doing business as Banner Drug Ltc.
Where is Eastside Pharmacy Services, LLC located?
Eastside Pharmacy Services, LLC is located at 308A Mocksville Hwy, Statesville, NC 28625. The listed phone number is (704) 878-6681.
What is Eastside Pharmacy Services, LLC's specialty?
The primary specialty registered for this NPI is Pharmacy, specializing in Long Term Care Pharmacy, with taxonomy code 3336L0003X.
Does Eastside Pharmacy Services, LLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 34D2135031) is associated with this NPI, valid through August 13, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Eastside Pharmacy Services, LLC accept?
Health plans from Antidote Health Plan of Arizona, Inc., Antidote Health Plan of Ohio, Inc., Avera Health Plans, Baylor Scott and White Health Plan and Blue Cross Blue Shield of North Dakota and 11 other insurers list Eastside Pharmacy Services, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Eastside Pharmacy Services, LLC was last updated on August 22, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Banner Drug Ltc · NPI 1134719628
Long Term Care Pharmacy organization in Statesville, North Carolina. Organization record, active in the CMS NPPES registry since January 19, 2021.
## Identity
- **NPI:** 1134719628 (Entity type: Organization)
- **Enumerated:** January 19, 2021
- **Primary specialty:** Pharmacy - Long Term Care Pharmacy · taxonomy 3336L0003X
- **Legal business name:** Eastside Pharmacy Services, Llc
- **Organization subpart:** No
- **Authorized official:** Melinda Childress, OWNER
## Practice location
- **Address:** 308A MOCKSVILLE HWY, Statesville, NC 28625-8267
- **Phone:** (704) 878-6681
## Record status
- **NPPES last updated:** August 22, 2022
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1134719628) · Data from the CMS NPPES public registry.