Southside Pharmacy

Primary specialty

PharmacyTaxonomy code 333600000X

License

P06644 Issued in KY

Legal business name

SOUTHSIDE PHARMACY

Practice address

102 E Main St
Earlington, KY 42410-1334

Phone

(270) 383-3784

Fax

(270) 383-3297

NPI assigned

Oct 19, 2006

Organization subpart

No

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

Authorized official

Name

Mike Seiber, R.PH.

Title

Pharmacist

Phone

(270) 383-3784

Specialties & licenses 6

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1104908359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 E MAIN ST",
            "city": "EARLINGTON",
            "state": "KY",
            "postal_code": "424101334",
            "telephone_number": "270-383-3784",
            "fax_number": "270-383-3297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 E MAIN ST",
            "city": "EARLINGTON",
            "state": "KY",
            "postal_code": "424101334",
            "telephone_number": "270-383-3784",
            "fax_number": "270-383-3297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHSIDE PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-19",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "SEIBER",
        "authorized_official_first_name": "MIKE",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "270-383-3784",
        "authorized_official_credential": "R.PH."
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "KY",
            "license": "011354",
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "KY",
            "license": "P06644",
            "primary": false
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "KY",
            "license": "P06644",
            "primary": false
        },
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "KY",
            "license": "P06644",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "KY",
            "license": "P06644",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "KY",
            "license": "P06644",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "54002274",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Community Care of Kentucky, Inc
• Mike'S Pharmacy, LLC
• Regional Health Care Affiliates Inc
• Tammy Renee Sanders, DMD
• Kristina Anne Sifuentes, APRN FNP-BC

• All providers in Earlington, KY
• Pharmacy in Kentucky

• 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.