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SOUTHSIDE FAMILY PHARMACY INC NPI 1396753927


NPI Information

NPI: 1396753927
Provider Name: SOUTHSIDE FAMILY PHARMACY INC

Doing Business As: SOUTHSIDE FAMILY PHARMACY, INC,

Classification: Pharmacy - 3336C0003X
Entity Type: Organization

Specialization: Community/Retail Pharmacy

CLIA Number: 01D2188458

Address:
1250 HIGHWAY 77
SOUTHSIDE, AL
ZIP 35907
Phone: (256) 413-4473
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SOUTHSIDE FAMILY PHARMACY INC is a community/retail pharmacy pharmacy in Southside, AL. The provider is a pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. SOUTHSIDE FAMILY PHARMACY INC NPI is 1396753927. The provider is registered as an organization entity type.
The provider Is Doing Business As Southside Family Pharmacy, Inc,.

The provider's business location address is:

1250 HIGHWAY 77
SOUTHSIDE, AL
ZIP 35907-405
Phone: (256) 413-4473
Fax: (256) 413-7358

The provider's authorized official is Tracy Boggs .
The authorized official title is Owner and has the following contact phone number (256) 413-4473.

The CLIA number assigned to this NPI record is 01D2188458 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/3/2006 and was last updated on 1/14/2021.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1333600000XPharmacyNo
23336C0003XPharmacyCommunity/Retail Pharmacy112170ALABAMAYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
12137549OTHERPK
2142548MEDICAIDALABAMA

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: 4/28/2024

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.