Organization
SOUTHSIDE PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIKE SEIBER R.PH. (PHARMACIST)
(270) 383-3784
Entity
Organization
Contact information
Practice address
102 E MAIN ST, EARLINGTON, KY 42410-1334
(270) 383-3784
(270) 383-3297
Mailing address
102 E MAIN ST, EARLINGTON, KY 42410-1334
(270) 383-3784
(270) 383-3297
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
011354
KY
332B00000X
Durable Medical Equipment & Medical Supplies
P06644
KY
332BC3200X
Customized Equipment (DME)
P06644
KY
332BX2000X
Oxygen Equipment & Supplies (DME)
P06644
KY
333600000X
Pharmacy
Primary
P06644
KY
3336C0003X
Community/Retail Pharmacy
P06644
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
54002274
—
KY
Enumeration date
10/19/2006
Last updated
09/11/2025
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