Southside Pharmacy LLC

NPI #1104186212 in Conway, South Carolina

Provider Information

NPI Number
1104186212
Entity Type
Organization
Organization Name
Southside Pharmacy LLC
Primary Specialty
Pharmacy - Community/Retail Pharmacy
Enumeration Date
May 22, 2012
Last Updated
Jan 17, 2014

Practice Location

Address
3320 4TH AVE STE F
City
Conway
ZIP Code
29527-6057
Phone
(843) 248-6550

Authorized Official

Name
JOHNNY CAPPS
Title
PRESIDENT/PHARMACIST IN CHARGE
Phone
(843) 248-6550

Specialties & Taxonomy Codes

Specialty
Pharmacy - Community/Retail PharmacyCommunity/Retail Pharmacy

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