Organization
SOUTHSIDE MASTER LLC
Active
Other names
Southside Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
AMIT JAIN (CEO)
(713) 660-8888
Entity
Organization
Contact information
Practice address
755 MOUNT VERNON HWY, SUITE 450, ATLANTA, GA 30328-4292
(470) 377-4054
(470) 377-4055
Mailing address
6330 WEST LOOP SOUTH, SUITE 700, 7TH FLOOR, BELLAIRE, TX 77401-2928
(713) 660-8888
(713) 661-4828
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Enumeration date
05/07/2019
Last updated
11/19/2019
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