| NPI | 1104186212 |
|---|---|
| Doing Business As | SOUTHSIDE PHARMACY |
| Entity Type | Organization |
| Authorized Contact | JOHNNY CAPPS President/Pharmacist In Charge 843-248-6550 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: SC 13996) |
| Enumeration Date | 2012-05-22 |
| Last Update Date | 2014-01-17 |