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SOUTHSIDE PHARMACY NPI 1104908359


NPI Information

NPI: 1104908359
Provider Name: SOUTHSIDE PHARMACY
Classification: Pharmacist - 183500000X
Entity Type: Organization
Address:
102 E MAIN ST
EARLINGTON, KY
ZIP 42410
Phone: (270) 383-3784
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SOUTHSIDE PHARMACY is a pharmacist in Earlington, KY. The provider is an individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. SOUTHSIDE PHARMACY NPI is 1104908359. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

102 E MAIN ST
EARLINGTON, KY
ZIP 42410-334
Phone: (270) 383-3784
Fax: (270) 383-3297

The provider's authorized official is Mike Seiber .
The authorized official title is Pharmacist and has the following contact phone number (270) 383-3784.

The enumeration date for this NPI number is 10/19/2006 and was last updated on 8/22/2020.


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:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1183500000XPharmacist011354KENTUCKYYes
23336C0003XPharmacyCommunity/Retail PharmacyP06644KENTUCKYX
3332BX2000XDurable Medical Equipment & Medical SuppliesOxygen Equipment & SuppliesP06644KENTUCKYX
4332B00000XDurable Medical Equipment & Medical SuppliesP06644KENTUCKYX
5332BC3200XDurable Medical Equipment & Medical SuppliesCustomized EquipmentP06644KENTUCKYX
6333600000XPharmacyP06644KENTUCKYX

Other Identifiers

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

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
154002274MEDICAIDKENTUCKY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.