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
- State
- South Carolina
- 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 Pharmacy — Community/Retail Pharmacy |
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