Southside Pharmacy of Lorain Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

022447550 Issued in OH

Legal business name

SOUTHSIDE PHARMACY OF LORAIN INC

Doing business as

Southside Pharmacy of Lorain Inc

Practice address

2811 Fulton Rd
Ste B
Lorain, OH 44055-1638

Phone

(440) 277-0655

Fax

(440) 277-0651

NPI assigned

Sep 3, 2014

Organization subpart

No

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

Authorized official

Name

Naser Taher

Title

Owner

Phone

(440) 277-0655

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Southside Pharmacy of Lorain Inc Doing business as

Locations

Practitioners 1

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

• Domia Taher

  • Pharmacist
  • Cleveland, OH
  • NPI 1568172641
  NPD (past)

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

{
    "created_epoch": "1409702400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1419897600000",
    "number": "1992105472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2811 FULTON RD",
            "address_2": "STE B",
            "city": "LORAIN",
            "state": "OH",
            "postal_code": "440551638",
            "telephone_number": "440-277-0655",
            "fax_number": "440-277-0651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2811 FULTON RD",
            "address_2": "STE B",
            "city": "LORAIN",
            "state": "OH",
            "postal_code": "440551638",
            "telephone_number": "440-277-0655",
            "fax_number": "440-277-0651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHSIDE PHARMACY OF LORAIN INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-03",
        "last_updated": "2014-12-30",
        "status": "A",
        "authorized_official_last_name": "TAHER",
        "authorized_official_first_name": "NASER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "440-277-0655"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OH",
            "license": "022447550",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2148083",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0113462",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southside Pharmacy of Lorain Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jessica L Songer, QMHS CMS
• Emma Kirsten Sonnenberg, LSW
• Nicole Marie Soptelean, FNP-C
• Josue Soto
• Kaylyn Mae Soto, LSW
• Kristine Sovich
• Aleksandar Spasic
• Michael Anthony Spataro, RN
• Spectrum Consulting Services
• Sharon Rochelle Spencer

• Community/Retail Pharmacy in Lorain, OH
• Providers in Lorain, OH by specialty
• Community/Retail Pharmacy in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2014; 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.