Organization
SOUTHSIDE PHARMACY OF LORAIN INC
Active
Other names
Southside Pharmacy of Lorain Inc
Organization subpart
No
Provider details
NPI number
Authorized official
NASER TAHER (OWNER)
(440) 277-0655
Entity
Organization
Contact information
Practice address
2811 FULTON RD, STE B, LORAIN, OH 44055-1638
(440) 277-0655
(440) 277-0651
Mailing address
2811 FULTON RD, STE B, LORAIN, OH 44055-1638
(440) 277-0655
(440) 277-0651
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
022447550
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0113462
—
OH
01
—
2148083
PK
—
Enumeration date
09/03/2014
Last updated
12/30/2014
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