Northside Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

60002352A Issued in IN

Legal business name

NORTHSIDE PHARMACY INC

Doing business as

North Side Pharmacy

Practice address

1160 E Saint Clair St
Vincennes, IN 47591-4853

Phone

(812) 882-1064

Fax

(812) 882-4004

NPI assigned

Sep 12, 2006

Organization subpart

No

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

Authorized official

Name

Robert Palmer, RPH

Title

President

Phone

(812) 882-1064

Specialties & licenses 4

Addresses

Other identifiers 2

Other names 1

• NORTH SIDE PHARMACY Doing business as

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

{
    "created_epoch": "1158019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297036800000",
    "number": "1285738237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1160 E SAINT CLAIR ST",
            "city": "VINCENNES",
            "state": "IN",
            "postal_code": "475914853",
            "telephone_number": "812-882-1064",
            "fax_number": "812-882-4004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1160 E SAINT CLAIR ST",
            "city": "VINCENNES",
            "state": "IN",
            "postal_code": "475914853",
            "telephone_number": "812-882-1064",
            "fax_number": "812-882-4004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHSIDE PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-12",
        "last_updated": "2011-02-07",
        "status": "A",
        "authorized_official_last_name": "PALMER",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "812-882-1064",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IN",
            "license": "60002352A",
            "primary": true
        },
        {
            "code": "3336H0001X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Home Infusion Therapy Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "1514430",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100177930A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NORTH SIDE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Heather Ruthann Nichols, M.D.
• Paige Nichols, RN
• Jacy Adam Nicholson, D.D.S.
• Jacob Nidey, LSW
• Teresa Jeanne Niehaus, OTR
• Kevin Edward Nowakowski, MD
• Thomas Patrick O'Rourke, M.D.
• Tara Lynn Oakley, LSW
• Patricia B Ochs, NP-C
• Chiedozie Max Ofoma, MD

• Community/Retail Pharmacy in Vincennes, IN
• Providers in Vincennes, IN by specialty
• Community/Retail Pharmacy in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2011; 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.