OrganizationActive
Eastside Pharmacy Services, LLC
NPI 1629630348 · Community/Retail Pharmacy · Troutman, NC
Provider details
- NPI number
- 1629630348
- Entity type
- Organization
- Primary specialty
- Community/Retail PharmacySuppliers
- Organization subpart
- No
- Authorized official
- Melinda Childress, Owner(704) 878-6681
Specialties & taxonomies
Suppliers
Profile Score
Established profile(66/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
6 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
106 Wagner St
Troutman, NC 28166-9627
Phone: (704) 528-6611
Street-level locationGet directions
Mailing address
3478 E Broad St
Statesville, NC 28625-4523
Other names (DBA / former)
- Doing business as
- Banner Drug of Troutman
Registry dates
- Enumerated
- 2019-07-02
- Last updated
- 2019-07-02
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.