MEDICARE: EAST GOSHEN PHARMACY, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251F00000X	Home Infusion Agency

General Provider Information

NPI Number	:	1659987568
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EAST GOSHEN PHARMACY, LLC

Provider Business Mailing Address
First Line	:	3000 LAKESIDE DR STE 300N
Second Line	:
City	:	BANNOCKBURN
State	:	IL
Zip	:	60015-5405
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	970 RITTENHOUSE RD STE 200
Second Line	:
City	:	AUDUBON
State	:	PA
Zip	:	19403-2265
Country	:	US
Telephone Number	:	800-551-0450
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT & CFO
Name	:	MEENAL SETHNA
Credential	:
Telephone Number	:	800-879-6137

Provider Enumeration Date	:	09/17/2020
Last Update Date	:	10/14/2025

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