SOUTHSIDE PHARMACY NPI 1104908359

NPI Information

  • NPI: 1104908359
  • Provider Name: SOUTHSIDE PHARMACY
  • Classification: Pharmacy - 333600000X
  • Entity Type: Organization
  • Address: 102 E MAIN ST
    EARLINGTON, KY
    ZIP 42410
  • Phone: (270) 383-3784

Map and Directions

Get Directions

NPI Details

SOUTHSIDE PHARMACY is a pharmacy in Earlington, KY. The provider is a facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. 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 9/11/2025.

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
1183500000XPharmacist011354KENTUCKYNo
23336C0003XPharmacyCommunity/Retail PharmacyP06644KENTUCKYNo
3332BX2000XDurable Medical Equipment & Medical SuppliesOxygen Equipment & SuppliesP06644KENTUCKYNo
4332B00000XDurable Medical Equipment & Medical SuppliesP06644KENTUCKYNo
5332BC3200XDurable Medical Equipment & Medical SuppliesCustomized EquipmentP06644KENTUCKYNo
6333600000XPharmacyP06644KENTUCKYYes

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: 11/21/2025

NPI Synchronization or Removal

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.