Southside Community Health Services, Inc.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

SOUTHSIDE COMMUNITY HEALTH SERVICES, INC.

Practice address

1000 E Lake St
Minneapolis, MN 55407-1617

Phone

(612) 384-9248

NPI assigned

Aug 21, 2026

Last updated

Aug 21, 2026By the provider in NPPES

Organization subpart

Yes

Parent organization

SOUTHSIDE COMMUNITY HEALTH SERVICES, INC.As reported in NPPES

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

Authorized official

Name

Stacy Ferderer, PHARMD

Title

Director of Pharmacy

Phone

(612) 384-9248

Specialties & licenses 1

Addresses

Tax ID family

Southside Eye Care4 organizations share this tax ID, including this one

Part of

Southside Eye Care

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

• Southside Community Health Services, Inc.

  dba Southside East Lake Street Dental Clinic

  • Dentist
  • Minneapolis, MN
  • NPI 1376409276
  NPD tax ID
• Southside Community Health Services, Inc.

  • Dentist
  • Minneapolis, MN
  • NPI 1992822290
  NPD tax ID
• Southside Medical Clinic at the Adler Center

  • Family Medicine Physician
  • Minneapolis, MN
  • NPI 1700121084
  NPD tax ID

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

{
    "created_epoch": "1787270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787270400000",
    "number": "1356257083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 E LAKE ST",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554071617",
            "telephone_number": "612-384-9248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 E LAKE ST",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554071617",
            "telephone_number": "612-384-9248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHSIDE COMMUNITY HEALTH SERVICES, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTHSIDE COMMUNITY HEALTH SERVICES, INC.",
        "enumeration_date": "2026-08-21",
        "last_updated": "2026-08-21",
        "certification_date": "2026-08-21",
        "status": "A",
        "authorized_official_last_name": "FERDERER",
        "authorized_official_first_name": "STACY",
        "authorized_official_title_or_position": "DIRECTOR OF PHARMACY",
        "authorized_official_telephone_number": "612-384-9248",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Southgate Physical Therapy , LTD
• Southpointe Physical Therapy LLC
• Southside Care Center
• Southside Catering
• Southside Chiropractic, P.a.
• Southside Community Health Services, Inc. (Southside East Lake Street Dental Clinic)
• Southside Community Health Services, Inc.
• Southside Community Health Services, Inc.
• Southside Community Health Services, Inc.
• Southside Family Charter School

• Community/Retail Pharmacy in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Community/Retail Pharmacy in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2026; 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.