1. Home
  2. Directory
  3. Michigan
  4. Detroit
  5. Pharmacy
  6. NPI Profile

EASTSIDE PHARMACY
NPI 1720212681
Pharmacy - Community/Retail Pharmacy in Detroit, MI

Active since May 07, 2009
11854 E WARREN AVE, DETROIT, MI 48214(313) 579-1755(313) 579-2067 Get Directions Write a Review

NPPES record last updated: November 13, 2014. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Eastside Pharmacy NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EASTSIDE PHARMACY (NPI 1720212681) is a healthcare organization registered as a community/retail pharmacy in Detroit, Michigan and active in the NPI registry since May 2009. The organization lists Sam Khreizat, Owner, as its authorized official.

NPPES Registry Identity

NPI1720212681
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameEASTSIDE PHARMACY INC
Location Address11854 E WARREN AVEDetroit, MI 48214-1664
Mailing Address11854 E Warren AveDetroit, MI 48214-1664 · (313) 579-1755 · Fax (313) 579-2067
Phone(313) 579-1755
Fax(313) 579-2067
Organization SubpartNo
Authorized OfficialSam KhreizatOwner · (313) 579-1755
Enumeration DateMay 7, 2009
Last NPPES UpdateNovember 13, 2014
✔ NPI 1720212681 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
License✔ Licensed in MI · 5301009095
Definition
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.
Also ListedPharmacyTaxonomy 333600000X
Also ListedPharmacy · Compounding PharmacyTaxonomy 3336C0004X
11854 E WARREN AVE, Detroit, MI 48214
Open in Google Maps ↗

Other Names 1

Doing Business AsEastside Pharmacy

Other Identifiers 1

Other2120128Pk

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 Inc's NPI number?

The NPI number for Eastside Pharmacy Inc is 1720212681. It was assigned to this organization in the NPPES registry on May 7, 2009. The provider is doing business as Eastside Pharmacy.

Where is Eastside Pharmacy Inc located?

Eastside Pharmacy Inc is located at 11854 E Warren Ave, Detroit, MI 48214. The listed phone number is (313) 579-1755.

What is Eastside Pharmacy Inc's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.

When was this NPI record last updated?

The NPPES record for Eastside Pharmacy Inc was last updated on November 13, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.