| NPI | 1407121841 |
|---|---|
| Doing Business As | SOUTHSIDE PHARMACY LTD |
| Entity Type | Organization |
| Authorized Contact | DOUGLAS WUNDERLICH Pharmacist/Owner 320-249-0000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0002X Pharmacy, Clinic Pharmacy (Licence: MN 264130) |
| Enumeration Date | 2012-03-19 |
| Last Update Date | 2015-06-10 |