OrganizationActive
Southside Pharmacy LLC
NPI 1104186212 · Community/Retail Pharmacy · Conway, SC
Southside Pharmacy LLC is a Community/Retail Pharmacy organization in Conway, SC (NPI 1104186212).
Provider details
- NPI number
- 1104186212
- Entity type
- Organization
- Primary specialty
- Community/Retail PharmacySuppliers
- Organization subpart
- No
- Authorized official
- Johnny Capps, President/Pharmacist in Charge(843) 248-6550
- License
- 13996 (SC)
Specialties & taxonomies
Suppliers
Profile Score
Detailed profile(79/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
14 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
3320 4th Ave Ste F
Conway, SC 29527-6057
Phone: (843) 248-6550
Fax: (843) 248-6553
Approximate (ZIP-level) locationGet directions
Mailing address
3320 4th Ave Ste F
Conway, SC 29527-6057
Other names (DBA / former)
- Doing business as
- Southside Pharmacy
Registry dates
- Enumerated
- 2012-05-22
- Last updated
- 2014-01-17
Frequently asked questions
- What is Southside Pharmacy LLC's NPI number?
- Southside Pharmacy LLC's National Provider Identifier (NPI) is 1104186212, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Southside Pharmacy LLC?
- Southside Pharmacy LLC is classified in the NPPES registry as Community/Retail Pharmacy (Suppliers).
- Where is Southside Pharmacy LLC located?
- Southside Pharmacy LLC's practice location on file with NPPES is 3320 4th Ave Ste F, Conway, SC 29527-6057.
- What is Southside Pharmacy LLC's phone number?
- The practice phone number listed in the NPPES registry for Southside Pharmacy LLC is (843) 248-6550.
- Who is the authorized official for Southside Pharmacy LLC?
- The authorized official listed on Southside Pharmacy LLC's NPPES record is Johnny Capps, President/Pharmacist in Charge. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Southside Pharmacy LLC's NPI active?
- Yes — Southside Pharmacy LLC's NPI (1104186212) is active in the NPPES registry as of the last update on 2014-01-17.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.