| NPI | 1205296043 |
|---|---|
| Doing Business As | SOUTHSIDE SPECIALTY PHARMACY |
| Entity Type | Organization |
| Authorized Contact | IHAB HERRAKA Owner 472-242-2894 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 333600000X Pharmacy (Licence: AR AR20829) |
| Enumeration Date | 2016-03-04 |
| Last Update Date | 2016-03-04 |