Healthcare Provider Details

I. General information

NPI: 1932275690
Provider Name (Legal Business Name): EAST HILL PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/27/2006
Last Update Date: 09/15/2023
Certification Date: 09/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2899 N 12TH AVE
PENSACOLA FL
32503-4001
US

IV. Provider business mailing address

2899 N 12TH AVE
PENSACOLA FL
32503-4001
US

V. Phone/Fax

Practice location:
  • Phone: 850-438-7568
  • Fax: 850-438-0683
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPH13368
License Number StateFL

VIII. Authorized Official

Name: DENA FERMAN
Title or Position: THIRD PARTY PLAN COORDINATOR
Credential: RPH
Phone: 314-993-6000