Southside Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

113810 Issued in AL

Legal business name

SOUTHSIDE PHARMACY INC

Doing business as

Southside Pharmacy

Practice address

11964 Escue Dr Ste a
Tanner, AL 35671-3680

Phone

(256) 232-6588

Fax

(256) 232-6589

NPI assigned

Oct 6, 2011

Last updated

Jan 27, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Tammy GarrettNPI 1992280366

Title

Pharmacist/President

Phone

(256) 232-6588

Specialties & licenses 2

Addresses

Other names 1

• Southside Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Tammy V Garrett

  • Pharmacist
  • Tanner, AL
  • NPI 1992280366
  NPD (past) Authorized official
• Scott J Garrett, PHARMD

  • Pharmacist
  • Tanner, AL
  • NPI 1215774625
  NPD

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

{
    "created_epoch": "1317859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453852800000",
    "number": "1548544752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11964 ESCUE DR",
            "address_2": "SUITE A",
            "city": "TANNER",
            "state": "AL",
            "postal_code": "356713679",
            "telephone_number": "256-232-6588",
            "fax_number": "256-232-6589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11964 ESCUE DR STE A",
            "city": "TANNER",
            "state": "AL",
            "postal_code": "356713680",
            "telephone_number": "256-232-6588",
            "fax_number": "256-232-6589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHSIDE PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-06",
        "last_updated": "2016-01-27",
        "status": "A",
        "authorized_official_last_name": "GARRETT",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_title_or_position": "PHARMACIST/PRESIDENT",
        "authorized_official_telephone_number": "256-232-6588"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "AL",
            "license": "113810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southside Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Traci McLin
• Scott Allen Parvin, D.M.D.
• Tracy L Pool, MD
• Chelsea Poss, CRNP
• Stanley Farrell Smallwood, CRNP-APRN-BC
• Tammy V Garrett
• Tanner Community Care
• Tanner Medical Clinic LLC

• Community/Retail Pharmacy in Tanner, AL
• Providers in Tanner, AL by specialty
• Community/Retail Pharmacy in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.