| NPI | 1801817879 |
|---|---|
| Doing Business As | SOUTH SIDE DRUG |
| Entity Type | Organization |
| Authorized Contact | MARK FRAHM Vice President 641-682-3467 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: IA 597) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 333600000X Pharmacy | |
| Enumeration Date | 2006-07-22 |
| Last Update Date | 2020-05-09 |