# SOUTH SIDE DRUG INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** SOUTH SIDE DRUG INC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1942765284
- **Legal business name:** SOUTH SIDE DRUG INC
- **Authorized official:** MR. MARK L FRAHM RPH (VICE-PRESIDENT)
- **Authorized official phone:** (641) 682-3467

## Contact information

- **Practice address:** 337 CHURCH ST, OTTUMWA, IA 52501-4294
- **Practice address phone:** (641) 682-3467
- **Practice address fax:** (641) 682-8822
- **Mailing address:** 337 CHURCH ST, OTTUMWA, IA 52501-4294
- **Mailing address phone:** (641) 682-3467
- **Mailing address fax:** (641) 682-8822

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 01/31/2019
- **Last updated:** 12/20/2019