SOUTHSIDE PHARMACY LTD NPI 1407121841

NPI Information

SOUTHSIDE PHARMACY LTD is a clinic pharmacy pharmacy in Saint Cloud, MN. The provider is a pharmacy in a clinic, emergency room or hospital (outpatient) that dispenses medications to patients for self-administration under the supervision of a pharmacist. SOUTHSIDE PHARMACY LTD NPI is 1407121841. The provider is registered as an organization entity type.
The provider Is Doing Business As Southside Pharmacy Ltd.

The provider's business location address is:

1301 33RD ST S
SAINT CLOUD, MN
ZIP 56301-668
Phone: (320) 259-0000
Fax: (320) 259-0001

The provider's authorized official is Douglas Wunderlich .
The authorized official title is Pharmacist/owner and has the following contact phone number (320) 249-0000.

The enumeration date for this NPI number is 3/19/2012 and was last updated on 6/10/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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