Organization Active NPI

North Side Pharmacy, Inc.

  • Durable Medical Equipment & Medical Supplies
  • McKinney, TX
National Provider Identifier
1093866212
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
NORTH SIDE PHARMACY, INC.
Practice address
1601 W University Dr
McKinney, TX 75069-3445
Phone
(972) 542-4481
Fax
(972) 542-3709
NPI assigned
Jan 15, 2007
Last updated
Sep 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. James Edward Petkovsek
Title
Mannger
Phone
(972) 542-4481

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary
Pharmacy 333600000X 01911 TX

Addresses

Primary practice location

1601 W University Dr
McKinney, TX 75069-3445

Mailing address

1601 W University Dr
McKinney, TX 75069-3445
Phone (972) 542-4481

Other identifiers 1

IdentifierTypeStateIssuer
4511829OtherTXPHARMACY NABP

National Provider Directory

National Provider Directory

Locations

1601 W University Dr
McKinney, TX 75069
Phone (972) 542-4481

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168819200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1093866212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 W UNIVERSITY DR",
            "city": "MCKINNEY",
            "state": "TX",
            "postal_code": "750693445",
            "telephone_number": "972-542-4481",
            "fax_number": "972-542-3709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 W UNIVERSITY DR",
            "city": "MCKINNEY",
            "state": "TX",
            "postal_code": "750693445",
            "telephone_number": "972-542-4481",
            "fax_number": "972-542-3709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH SIDE PHARMACY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-15",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "PETKOVSEK",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "MANNGER",
        "authorized_official_telephone_number": "972-542-4481",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "TX",
            "license": "01911",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACY NABP",
            "identifier": "4511829",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in McKinney, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.