Organization
WESTSIDE PHARMACY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID W DEXTER R.PH. (PRESIDENT)
(770) 387-3455
Entity
Organization
Contact information
Practice address
775 WEST AVE, SUITE C, CARTERSVILLE, GA 30120-3481
(770) 387-3455
(770) 387-3465
Mailing address
775 WEST AVE, SUITE C, CARTERSVILLE, GA 30120-3481
(770) 387-3455
(770) 387-3465
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
PHRE008729
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0008141736C
—
GA
01
—
1151048
NCPDP
—
Enumeration date
09/20/2006
Last updated
03/07/2023
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