Provider Demographics
NPI:1740012038
Name:EAST END EXPRESS PHARMACY INC
Entity type:Organization
Organization Name:EAST END EXPRESS PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY/TREASURER
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:B
Authorized Official - Last Name:GREENE
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:501-486-4100
Mailing Address - Street 1:21019 HIGHWAY 167 STE 100
Mailing Address - Street 2:
Mailing Address - City:HENSLEY
Mailing Address - State:AR
Mailing Address - Zip Code:72065-8154
Mailing Address - Country:US
Mailing Address - Phone:501-486-4100
Mailing Address - Fax:
Practice Address - Street 1:21019 HIGHWAY 167 STE 100
Practice Address - Street 2:
Practice Address - City:HENSLEY
Practice Address - State:AR
Practice Address - Zip Code:72065-8154
Practice Address - Country:US
Practice Address - Phone:501-486-4100
Practice Address - Fax:501-486-4101
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EAST END EXPRESS PHARMACY, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-08-15
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy