| NPI | 1922058890 |
|---|---|
| Doing Business As | NORTHSIDE PHARMACY |
| Entity Type | Organization |
| Authorized Contact | SHANE J CLARAMBEAU Owner/Pharmacist 605-352-9222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2021-04-30 |