| NPI | 1184778532 |
|---|---|
| Doing Business As | NORTHSIDE PHARMACY |
| Entity Type | Organization |
| Authorized Contact | NOLAN COURVILLE Managing Partner 337-232-2666 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: LA PHY004593IR) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2017-03-15 |