1. Home
  2. Directory
  3. South Carolina
  4. Conway
  5. Pharmacy
  6. NPI Profile

SOUTHSIDE PHARMACY
NPI 1104186212
Pharmacy - Community/Retail Pharmacy in Conway, SC

Active since May 22, 2012
3320 4TH AVE STE F, CONWAY, SC 29527(843) 248-6550(843) 248-6553 Get Directions Write a Review

NPPES record last updated: January 17, 2014. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Southside Pharmacy NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOUTHSIDE PHARMACY (NPI 1104186212) is a healthcare organization registered as a community/retail pharmacy in Conway, South Carolina and active in the NPI registry since May 2012. The organization lists Johnny Capps, President/pharmacist In Charge, as its authorized official.

NPPES Registry Identity

NPI1104186212
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameSOUTHSIDE PHARMACY LLC
Location Address3320 4TH AVE STE FConway, SC 29527-6057
Mailing Address3320 4th Ave Ste FConway, SC 29527-6057 · (843) 248-6550 · Fax (843) 248-6553
Phone(843) 248-6550
Fax(843) 248-6553
Organization SubpartNo
Authorized OfficialJohnny CappsPresident/pharmacist In Charge · (843) 248-6550
Enumeration DateMay 22, 2012
Last NPPES UpdateJanuary 17, 2014
✔ NPI 1104186212 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
License✔ Licensed in SC · 13996
Definition
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.
3320 4TH AVE STE F, Conway, SC 29527
Open in Google Maps ↗

Other Names 1

Doing Business AsSouthside Pharmacy

Other Identifiers 2

Other2135319Pk
Medicaid71399DSC

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. JOHNNY RAY CAPPS RPH
Pharmacist
3320 4TH AVE STE F
CONWAY, SC 29527
Horry County (843) 248-6550
TRACI S POWERS PHARMD
Pharmacist
3320 4TH AVE STE F
CONWAY, SC 29527
Horry County (843) 248-6550

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Southside Pharmacy LLC's NPI number?

The NPI number for Southside Pharmacy LLC is 1104186212. It was assigned to this organization in the NPPES registry on May 22, 2012. The provider is doing business as Southside Pharmacy.

Where is Southside Pharmacy LLC located?

Southside Pharmacy LLC is located at 3320 4th Ave Ste F, Conway, SC 29527. The listed phone number is (843) 248-6550.

What is Southside Pharmacy LLC's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.

When was this NPI record last updated?

The NPPES record for Southside Pharmacy LLC was last updated on January 17, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.