Northside Pharmacy, LLC
Organization Active NPI Community/Retail Pharmacy · Haleyville, AL
NPI 1902228067 · NPPES record last updated Oct 9, 2015
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128a(1) exclusion effective Sep 20, 2022.
Key facts
- NPI
- 1902228067
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- Legal business name
- NORTHSIDE PHARMACY, LLC
- Practice address
- 922 20TH St
Haleyville, AL 35594 - Phone
- (205) 486-3197
- Fax
- (205) 486-3198
- NPI assigned
- Jan 9, 2014
- Organization subpart
- No
Authorized official
- Name
- Mr. Jeffrey B South
- Title
- Operations Manager
- Phone
- (205) 486-3197
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
Locations
922 20th St
Haleyville, AL 35565
Phone (205) 486-3197
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | 114269 | AL | |
| Community/Retail Pharmacy | 3336C0003X | AL | Yes |
Addresses
Primary practice location
922 20TH St
Haleyville, AL 35594
Mailing address
922 20TH St
Haleyville, AL 35594
Phone (205) 487-0623
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2142376 | Other | PK |
Other names
- Global Pharmacy
Other providers in Haleyville, AL
- Beth K Moore
- Karen L Moore
- Michael N. Moore
- More Than Words Speech Pathology Services, LLC
- Julie Michelle Murray
- Northwest Alabama Mental Health Center
- Northwest Alabama Surgical Specialists, PC
- Northwest Chiropractic Clinic
- Northwest Diagnostics, LLC
- Orthosports Athens, LLC
All providers in Haleyville, AL · Community/Retail Pharmacy in Alabama
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 9, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- OIG LEIE (HHS Office of Inspector General).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.