Organization
SOUTHSIDE PHARMACY INC
Active
Other names
Southside Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
TAMMY GARRETT (PHARMACIST/PRESIDENT)
(256) 232-6588
Entity
Organization
Contact information
Practice address
11964 ESCUE DR STE A, TANNER, AL 35671-3680
(256) 232-6588
(256) 232-6589
Mailing address
11964 ESCUE DR, SUITE A, TANNER, AL 35671-3679
(256) 232-6588
(256) 232-6589
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
113810
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
134219
—
AL
01
—
2132353
PK
—
Enumeration date
10/06/2011
Last updated
01/27/2016
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