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General NPI Number Information
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NPI Number | 1356281786
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Entity Type | Organization
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Legal Business Name | SOUTHU LLC
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Dates
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Enumeration Date | 03/28/2026
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Last Update Date | 03/28/2026
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Provider Practice Location Address
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Address Line | 2181 PARKER ST NE STE C21
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City | CLEVELAND
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State | TN
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Zip | 37311-3924
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Country | US
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Telephone | 423-476-5548
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Fax |
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Provider Business Mailing Address
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Address Line | 578 CLASSIC TRL
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City | RINGGOLD
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State | GA
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Zip | 30736-5895
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Country | US
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Telephone | 423-718-8521
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Fax | 706-841-0442
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Authorized Official
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Title or Position | OWNER
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Name | DUSTIN ADAM BEARD
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Credential | PHARM.D.
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Telephone | 423-718-8521
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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