Southside Pharmacy 3
LBN: Ssrx Llc
Southside Pharmacy 3 is an health care organization with primary practice located at 6330 West Loop South Ste. 700 C, Bellaire TX 77401-2928. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy, Suppliers / Specialty Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty.
Ssrx Llc can be contacted via phone (832) 553-1374, or through Fetcenko, Mark via phone (832) 533-1301.
Contact Information
Primary practice address
6330 West Loop South Ste. 700 C
Bellaire TX 77401-2928
Phone: (832) 553-1374
Fax: (855) 822-7838
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Pharmacy | 333600000X | ||
| Suppliers / Community/Retail Pharmacy | 3336C0003X | 26659 | Texas |
| Suppliers / Specialty Pharmacy | 3336S0011X |
Profile Details
| NPI number | 1538496443 |
|---|---|
| LBN Legal business name | Ssrx Llc |
| DBA Doing business as | Southside Pharmacy 3 |
| Authorized official | Fetcenko, Mark |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Nov 13th, 2009 |
| Last updated | Mar 16th, 2022 - about 2 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1538496443 | NPPES |
| Texas | MEDICAID | 146091 | |
| Texas | Other | 2122749 | |
| Texas | MEDICAID | 149772 | |
| Texas | Other | 33989 |
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