| NPI | 1538496443 |
|---|---|
| Doing Business As | SOUTHSIDE PHARMACY 3 |
| Doing Business As | SSRX PHARMACY 3 |
| Entity Type | Organization |
| Authorized Contact | MARK FETCENKO COO Officer 832-533-1301 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: TX 26659) |
| Additional Taxonomies | 333600000X Pharmacy |
| 3336S0011X Pharmacy, Specialty Pharmacy | |
| Enumeration Date | 2009-11-13 |
| Last Update Date | 2022-03-16 |