Southside Drug Company Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

02204 Issued in NC

Legal business name

SOUTHSIDE DRUG COMPANY INC

Doing business as

SOUTHSIDE DRUG COMPANY

Practice address

1005 Nicholas St
Henderson, NC 27536-4945

Phone

(252) 438-5128

Fax

(252) 438-5129

NPI assigned

Sep 30, 2006

Organization subpart

No

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

Authorized official

Name

Morris Hedgepeeth, BS IN PHARMACY

Title

President/Owner

Phone

(252) 438-5128

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• SOUTHSIDE DRUG COMPANY Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Morris Edward Hedgepeth, RPH

  • Pharmacist
  • Henderson, NC
  • NPI 1528328267
  NPD (past)

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

{
    "created_epoch": "1159574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424044800000",
    "number": "1235222662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1005 NICHOLAS ST",
            "city": "HENDERSON",
            "state": "NC",
            "postal_code": "275364945",
            "telephone_number": "252-438-5128",
            "fax_number": "252-438-5129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 NICHOLAS ST",
            "city": "HENDERSON",
            "state": "NC",
            "postal_code": "275364945",
            "telephone_number": "252-438-5128",
            "fax_number": "252-438-5129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHSIDE DRUG COMPANY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-30",
        "last_updated": "2015-02-16",
        "status": "A",
        "authorized_official_last_name": "HEDGEPEETH",
        "authorized_official_first_name": "MORRIS",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "252-438-5128",
        "authorized_official_credential": "BS IN PHARMACY"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NC",
            "license": "02204",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0915033",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2067809",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SOUTHSIDE DRUG COMPANY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Henderson, NC
• Providers in Henderson, NC by specialty
• Community/Retail Pharmacy in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2015; 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.