SOUTH SIDE DRUG INC (NPI# 1942765284) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942765284 |
| Entity Type | Organization |
| Organization Name | SOUTH SIDE DRUG INC |
| Practice Address |
337 Church St Ottumwa IA 52501-4294 |
| Practice Telephone | 6416823467 |
| Practice Fax Number | 6416828822 |
| Mailing Telephone | 6416823467 |
| Mailing Fax Number | 6416828822 |
| Enumeration Date | 2019-01-31 |
| Last Update Date | 2019-12-20 |
| Authorized Official Name | MR. MARK L FRAHM (VICE-PRESIDENT) |
| Authorized Official Telephone | 6416823467 |
| Authorized Official Credential | RPH |
| Is Organization Subpart | Y |
| Parent Organization Name | SOUTH SIDE DRUG INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
Suppliers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801817879 | South Side Drug Inc | Durable Medical Equipment & Medical Supplies | 337 Church St, Ottumwa, IA 52501-4212 | 2006-07-22 |
| Street Address |
337 CHURCH ST |
| City | OTTUMWA |
| State | IA |
| Zip Code | 52501-4294 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801817879 | South Side Drug Inc | Durable Medical Equipment & Medical Supplies | 337 Church St, Ottumwa, IA 52501-4212 | 2006-07-22 |
| 1154971570 | Kimberly Robinson | Pharmacist | 337 Church St, Ottumwa, IA 52501-4294 | 2019-09-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205327210 | Speer Family Chiropractic, LLC | Chiropractor | 635 Pennsylvania Ave, Ottumwa, IA 52501 | 2018-05-24 |
| 1982194874 | Jasmine Benson | Nurse Practitioner | 1013 Pennsylvania Avenue, Suite A/b, Ottumwa, IA 52501 | 2018-05-16 |
| 1265957567 | Katie Marie Walz | Registered Nurse | 725 W. Second St., Ottumwa, IA 52501 | 2017-08-08 |
| 1033648431 | Cassadie Roberts | Occupational Therapy Assistant | 3 Pennsylvania Place, Ottumwa, IA 52501 | 2017-06-08 |
| 1588900880 | Ottumwa Er LLC | Emergency Medicine | 1001 Pennsylvania Avenue, Ottumwa, IA 52501 | 2012-12-14 |
| 1710258009 | Alcohol & Drug Dependency Services | Clinic/Center | 226 West Main St., Ottumwa, IA 52501 | 2012-01-19 |
| 1477832921 | Melissa Rohrssen | Physical Therapy Assistant | 13 Bear Creek Estates Drive, Ottumwa, IA 52501 | 2011-08-15 |
| 1578855201 | Brandy S.n. Jeansimon | Obstetrics & Gynecology | 1001 E. Pennsylvania Avenue, Ottumwa, IA 52501 | 2011-05-13 |
| 1801120399 | Frank Sam Harper | Counselor | 310 W. Main St., Ottumwa, IA 52501 | 2009-09-30 |
| 1902078439 | Sandro Younadam | Internal Medicine | 1013 Pennsylvania Avenue Suite A, Ottumwa Regional Health Center, Ottumwa, IA 52501 | 2008-03-25 |
| Find all providers in zip 52501 | ||||
| Taxonomy Code | 3336L0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Long Term Care Pharmacy |
| A pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities for mentally retarded, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063070985 | Pm Acquisition, LLC | Pharmacy | 107 W Main St Ste B, Ottumwa, IA 52501-2542 | 2019-06-05 |
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|---|---|---|---|---|
| 1144864950 | Pm Acquisition, LLC | Pharmacy | 4927 Maple Dr Ste 200, Pleasant Hill, IA 50327-2030 | 2019-11-05 |
| 1992348882 | Pharmscript of Ia LLC | Pharmacy | 2601 104th St Ste 300, Urbandale, IA 50322-3954 | 2019-10-23 |
| 1720543812 | Greenfield Pharmacy LLC | Pharmacy | 202 Se Kent St Ste 1, Greenfield, IA 50849-1411 | 2019-02-04 |
| 1508339425 | Pm Acquisition, LLC | Pharmacy | 2039 Crossroads Blvd Ste B, Waterloo, IA 50702-4403 | 2019-01-03 |
| 1427533165 | Consultant Pharmacists Inc | Pharmacy | 714 Illinois St, Sidney, IA 51652-8027 | 2018-09-28 |
| 1912486226 | Gbank Health LLC | Pharmacy | 617 8th Ave Se Ste C, Cedar Rapids, IA 52401-2117 | 2018-08-08 |
| 1811475064 | Gbank Health LLC | Pharmacy | 876 Tanglefoot Ln, Bettendorf, IA 52722-1605 | 2018-07-31 |
| 1588175103 | L & M Pharmacy Care | Pharmacy | 2526 Glenn Ave, Sioux City, IA 51106-2768 | 2017-10-23 |
| 1609393917 | Lewis Family Drug, LLC | Pharmacy | 528 S 3rd St, Moville, IA 51039 | 2017-08-28 |
| 1851773501 | Community Pharmacy Services Inc | Pharmacy | 5217 Grand Ave, Davenport, IA 52807-1014 | 2015-06-18 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.