Organization
WESTSIDE DRUGS, INC
Active
Parent organization
WESTSIDE DRUGS, INC
Other names
SOUTH GEORGIA HOME HEALTHCARE
Organization subpart
Yes
Provider details
NPI number
Legal business name
WESTSIDE DRUGS, INC
Authorized official
MR. JIMMY DERREL CARTER RPH (PRES)
(912) 384-3057
Entity
Organization
Contact information
Practice address
308A WESTSIDE DR, DOUGLAS, GA 31533-3530
(912) 384-3057
Mailing address
308A WESTSIDE DR, DOUGLAS, GA 31533-3530
(912) 384-3057
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00135154B
—
GA
Enumeration date
11/30/2007
Last updated
11/30/2007
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