EASTSIDE PHARMACY AND CUSTOM COMPOUNDING, INC.
NPI 1881884161
Pharmacy - Community/Retail Pharmacy in Athens, AL

Q: What is Eastside Pharmacy And Custom Compounding, Inc.'s specialty?

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

Active since August 01, 2007CLIA 01D2098979 · Waiver

1406 LINDSAY LANE SOUTH, SUITE A, ATHENS, AL 35613(256) 233-7070(256) 233-8891 Get Directions Write a Review

NPPES record last updated: March 23, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Eastside Pharmacy And Custom Compounding, Inc. NPPES

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

EASTSIDE PHARMACY AND CUSTOM COMPOUNDING, INC. (NPI 1881884161) is a healthcare organization registered as a community/retail pharmacy in Athens, Alabama and active in the NPI registry since August 2007. The organization holds a CLIA Waiver certificate valid through July 19, 2027 and lists Monique D. Cannon, President, as its authorized official.

NPPES Registry Identity

NPI1881884161

Entity TypeOrganization

Primary Taxonomy3336C0003X

Legal Business NameEASTSIDE PHARMACY AND CUSTOM COMPOUNDING, INC.

Location Address1406 LINDSAY LANE SOUTH, SUITE AAthens, AL 35613

Mailing Address1406 Lindsay Lane South, Suite AAthens, AL 35613 · (256) 233-7070 · Fax (256) 233-8891

Phone(256) 233-7070

Fax(256) 233-8891

Organization SubpartNo

Authorized OfficialMonique D. CannonPresident · (256) 233-7070

Enumeration DateAugust 1, 2007

Last NPPES UpdateMarch 23, 2021

NPPES CertifiedMarch 2, 2021

✔ NPI 1881884161 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers

Taxonomy Code3336C0003X

License✔ Licensed in AL · 112977

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 ListedDurable Medical Equipment & Medical SuppliesTaxonomy 332B00000X

1406 LINDSAY LANE SOUTH, Athens, AL 35613

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Other Identifiers 1

Medicaid100039186AL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter from Arizona Complete Health and more.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 01D2098979

Eastside Pharmacy And Custom Compounding Inc · Athens, AL

Active · expires Jul 19, 2027

CLIA Number01D2098979

Laboratory TypePharmacy

Certificate Effective DateJuly 20, 2025

Certificate Expiration DateJuly 19, 2027

Laboratory DirectorMonique D. Cannon

Laboratory Phone(256) 233-7070

Laboratory LocationEastside Pharmacy And Custom Compounding Inc1406 Lindsay Lane South, Suite A, Athens, AL 35613

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

31 services31 patients

Influenza vaccine, inactivated 90653

The Influenza vaccine, inactivated, is a shot given to protect against the flu. It contains killed virus particles that help your body build immunity to the flu. It's recommended annually to keep your protection up-to-date. It's safe for ages 6 months and up.

28 services28 patients

Medical Equipment Supplier Medicare DMEPOS 19

Medicare supplier enrollment and the product categories Eastside Pharmacy And Custom Compou carries, from the Medicare DMEPOS supplier directory.

Eastside Pharmacy And Custom Compou

DMEPOS supplier · Athens, ALOperated by Eastside Pharmacy And Custom Compounding Inc

⋮

Does not accept Medicare assignment

Eastside Pharmacy And Custom Compou has not agreed to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients may be charged more than the Medicare-approved amount; confirm the expected cost with the supplier before ordering.

PTAN (Medicare Supplier Number)20683103

Medicare Participant SinceFebruary 4, 2008

Supplier Location1406 Lindsay Ln S Ste AAthens, AL 35613

Phone(256) 233-7070

Supplier Specialties

Pharmacy

Medicare Product Categories

Epoetin

Epoetin is a man-made version of human erythropoietin (EPO)

Immunosuppressive Drugs

Immunosuppressive drugs require dosage, frequency, and route of administration to prevent or treat the rejection of an organ transplant

Nebulizer Drugs

Albuterol, levalbuterol, and metaproterenol are all short-acting bronchodilators with beta-adrenergic stimulatory effect

Oral Anticancer Drugs

FDA anticancer drugs

Oral Antiemetic Drugs

FDA antiemetic drugs

Commodes, Urinals, Bedpans

Raised toilets, Drop-arm commodes, Folding commodes, Plastic urinals, Plastic bedpans, Disposable urinals

Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MONIQUE D. CANNON PHARM.D.

Pharmacist

1406 LINDSAY LANE SOUTH, SUITE A
ATHENS, AL 35613

Limestone County (256) 233-7070

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 And Custom Compounding, Inc.'s NPI number?

The NPI number for Eastside Pharmacy And Custom Compounding, Inc. is 1881884161. It was assigned to this organization in the NPPES registry on August 1, 2007.

Where is Eastside Pharmacy And Custom Compounding, Inc. located?

Eastside Pharmacy And Custom Compounding, Inc. is located at 1406 Lindsay Lane South Suite A, Athens, AL 35613. The listed phone number is (256) 233-7070.

What is Eastside Pharmacy And Custom Compounding, Inc.'s specialty?

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

Does Eastside Pharmacy And Custom Compounding, Inc. accept Medicare assignment for medical equipment?

No. As a Medicare medical equipment supplier, Eastside Pharmacy And Custom Compou does not accept Medicare assignment for equipment and supplies, so patients may be charged more than the Medicare-approved amount. Confirm the expected cost with the supplier before ordering.

Does Eastside Pharmacy And Custom Compounding, Inc. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 01D2098979) is associated with this NPI, valid through July 19, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Eastside Pharmacy And Custom Compounding, Inc. accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter Health of Delaware, Ambetter from Absolute Total Care and Ambetter from Arizona Complete Health and 47 other insurers list Eastside Pharmacy And Custom Compounding, Inc. 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 And Custom Compounding, Inc. was last updated on March 23, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.