Organization
SOUTHSIDE DRUGS INC
Active
Other names
SOUTHSIDE DISCOUNT DRUGS
Organization subpart
No
Provider details
NPI number
Authorized official
BEN BRADDY (VP)
(478) 453-7227
Entity
Organization
Contact information
Practice address
200 W ANDREWS ST, MILLEDGEVILLE, GA 31061-3839
(478) 453-7227
(478) 452-9789
Mailing address
200 W ANDREWS ST, MILLEDGEVILLE, GA 31061-3839
(478) 453-7227
(478) 452-9789
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHRE007221
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00439227A
—
GA
01
—
2017479
PK
—
Enumeration date
11/10/2006
Last updated
04/22/2016
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