<Unavail>

LBN: Southside Pharmacy Ltd
<Unavail> is an health care organization with primary practice located at 1301 33Rd St S , Saint Cloud MN 56301-9668. The organization recently has only one registered license in Suppliers / Community/Retail Pharmacy, which is considered as the primary health care specialty. Southside Pharmacy Ltd can be contacted via phone (320) 259-0000, or through Wunderlich, Douglas via phone (320) 259-0000.

Contact Information

Primary practice address
1301 33Rd St S Saint Cloud MN 56301-9668
Phone: (320) 259-0000
Fax: (320) 259-0001
Website:
Map and Directions
Authorized official contact:
Name: Wunderlich, Douglas
Phone: (320) 259-0000

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Community/Retail Pharmacy 3336C0003X

Profile Details

NPI number 1407121841
LBN Legal business name Southside Pharmacy Ltd
DBA Doing business as <Unavail>
Authorized official Wunderlich, Douglas
Entity Organization
Organization subpart 1 No
Enumeration date Mar 19th, 2012
Last updated Jun 3rd, 2025 - about last year

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407121841 NPPES
Minnesota MEDICAID 1407121841

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