Organization
SOUTHSIDE PHARMACY LTD
Active
Other names
Southside Pharmacy LTD
Organization subpart
No
Provider details
NPI number
Authorized official
DOUGLAS WUNDERLICH (PHARMACIST/OWNER)
(320) 259-0000
Entity
Organization
Contact information
Practice address
1301 33RD ST S, SAINT CLOUD, MN 56301-9668
(320) 259-0000
(320) 259-0001
Mailing address
1301 33RD ST S, SAINT CLOUD, MN 56301-9668
(320) 259-0000
(320) 259-0001
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1407121841
—
MN
Enumeration date
03/19/2012
Last updated
06/03/2025
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