Healthcare Provider Details

I. General information

NPI: 1275511362
Provider Name (Legal Business Name): WESTSIDE PHARMACY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4440 W MAIN ST SUITE 1
DOTHAN AL
36305-1064
US

IV. Provider business mailing address

4440 W MAIN ST SUITE 1
DOTHAN AL
36305-1064
US

V. Phone/Fax

Practice location:
  • Phone: 334-699-6337
  • Fax: 334-699-6338
Mailing address:
  • Phone: 334-699-6337
  • Fax: 334-699-6338

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number112724
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number112724
License Number StateAL

VIII. Authorized Official

Name: MRS. DAWN CANNON WEST
Title or Position: SUPERVISING PHARMACIST OWNER
Credential: RPH
Phone: 334-699-6337