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SOUTHSIDE MASTER LLC NPI 1063077881


NPI Information

NPI: 1063077881
Provider Name: SOUTHSIDE MASTER LLC

Doing Business As: SOUTHSIDE PHARMACY

Classification: Pharmacy - 3336C0003X
Entity Type: Organization

Specialization: Community/Retail Pharmacy

Address:
755 MOUNT VERNON HWY
SUITE 450
ATLANTA, GA
ZIP 30328
Phone: (470) 377-4054
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SOUTHSIDE MASTER LLC is a community/retail pharmacy pharmacy in Atlanta, GA. The provider is a pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. SOUTHSIDE MASTER LLC NPI is 1063077881. The provider is registered as an organization entity type.
The provider Is Doing Business As Southside Pharmacy.

The provider's business location address is:

755 MOUNT VERNON HWY
SUITE 450
ATLANTA, GA
ZIP 30328-292
Phone: (470) 377-4054
Fax: (470) 377-4055

The provider's authorized official is Amit Jain .
The authorized official title is Ceo and has the following contact phone number (713) 660-8888.

The enumeration date for this NPI number is 5/7/2019 and was last updated on 11/19/2019.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
13336C0003XPharmacyCommunity/Retail PharmacyYes
23336S0011XPharmacySpecialty PharmacyNo

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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