MEDICARE: SOUTHU LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0003X	Community/Retail Pharmacy

General Provider Information

NPI Number	:	1356281786
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUTHU LLC

Provider Business Mailing Address
First Line	:	578 CLASSIC TRL
Second Line	:
City	:	RINGGOLD
State	:	GA
Zip	:	30736-5895
Country	:	US
Telephone Number	:	423-718-8521
Fax Number	:	706-841-0442

Provider Business Practice Location Address
First Line	:	2181 PARKER ST NE STE C21
Second Line	:
City	:	CLEVELAND
State	:	TN
Zip	:	37311-3924
Country	:	US
Telephone Number	:	423-476-5548
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DUSTIN ADAM BEARD
Credential	:	PHARM.D.
Telephone Number	:	423-718-8521

Provider Enumeration Date	:	03/28/2026
Last Update Date	:	03/28/2026

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Directions to “SOUTHU LLC ” Practice Location

Language	Start Address	Practice Location

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