# SOUTHSIDE MASTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Southside Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063077881
- **Authorized official:** AMIT JAIN (CEO)
- **Authorized official phone:** (713) 660-8888

## Contact information

- **Practice address:** 755 MOUNT VERNON HWY, SUITE 450, ATLANTA, GA 30328-4292
- **Practice address phone:** (470) 377-4054
- **Practice address fax:** (470) 377-4055
- **Mailing address:** 6330 WEST LOOP SOUTH, SUITE 700, 7TH FLOOR, BELLAIRE, TX 77401-2928
- **Mailing address phone:** (713) 660-8888
- **Mailing address fax:** (713) 661-4828

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | Yes |
| 3336S0011X | Specialty Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 05/07/2019
- **Last updated:** 11/19/2019