South Side Drug Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

597 Issued in IA

Legal business name

SOUTH SIDE DRUG INC

Doing business as

SOUTH SIDE DRUG

Practice address

337 Church St
Ottumwa, IA 52501-4212

Phone

(641) 682-3467

Fax

(641) 682-8822

NPI assigned

Jul 22, 2006

Organization subpart

No

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

Authorized official

Name

Mark Frahm, RPH

Title

Vice President

Phone

(641) 682-3467

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• SOUTH SIDE DRUG Doing business as

Medicare fee-for-service enrollment

Enrolled in IA2 enrollments

Enrollment records 2

Tax ID family

South Side Drug Store2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• South Side Drug Inc

  • Long Term Care Pharmacy
  • Ottumwa, IA
  • NPI 1942765284
  NPD tax ID

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• South Side Drug Inc

  • Long Term Care Pharmacy
  • Ottumwa, IA
  • NPI 1942765284
  NPPES parent name

Practitioners 1

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

• Kimberly Robinson, PHARMD

  • Pharmacist
  • Ottumwa, IA
  • NPI 1154971570
  NPD

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

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758240000000",
    "number": "1801817879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "337 CHURCH ST",
            "city": "OTTUMWA",
            "state": "IA",
            "postal_code": "525014212",
            "telephone_number": "641-682-3467",
            "fax_number": "641-682-8822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "337 CHURCH ST",
            "city": "OTTUMWA",
            "state": "IA",
            "postal_code": "525014212",
            "telephone_number": "641-682-3467",
            "fax_number": "641-682-8822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH SIDE DRUG INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-22",
        "last_updated": "2025-09-19",
        "certification_date": "2020-05-09",
        "status": "A",
        "authorized_official_last_name": "FRAHM",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "641-682-3467",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IA",
            "license": "597",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0052001",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2026297",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SOUTH SIDE DRUG",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SOUTH SIDE DRUG",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Catherine Ann Sims, FNP-BC
• Ashley Erin Smith, RN
• Amanda L Snow, RN
• William S Snyder III, FNP
• Jason John Sothman, D.C.
• South Side Drug Inc
• Southeast Iowa Chiropractic LLC
• Southeast Iowa Kidney Care, Hypertension and Medicine Clinic, LLC
• Southern Iowa Economic Development Assoc
• Southern Iowa Family Planning Clinic, Inc.

• Community/Retail Pharmacy in Ottumwa, IA
• Providers in Ottumwa, IA by specialty
• Community/Retail Pharmacy in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.