| NPI | 1851665954 |
|---|---|
| Doing Business As | SOUTHSIDE PHARMACY |
| Entity Type | Organization |
| Authorized Contact | MICHAEL BASSANELL Pharmacist 646-234-4181 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: NY 031088) |
| Additional Taxonomies | 3336S0011X Pharmacy, Specialty Pharmacy |
| 3336M0003X Pharmacy, Managed Care Organization Pharmacy | |
| 3336M0002X Pharmacy, Mail Order Pharmacy | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 3336C0004X Pharmacy, Compounding Pharmacy | |
| 3336H0001X Pharmacy, Home Infusion Therapy Pharmacy | |
| 333600000X Pharmacy | |
| 3336L0003X Pharmacy, Long Term Care Pharmacy | |
| Enumeration Date | 2012-03-07 |
| Last Update Date | 2024-01-18 |