Southside Pharmacy Ltd
Southside Pharmacy Ltd is a healthcare organization registered as Community/Retail Pharmacy in Saint Cloud, MN, holding Type 2 (organization) NPI 1669561163 since 2006. The authorized official on file is Doug Wunderlich, Ceo.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1669561163 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Southside Pharmacy Ltd |
| Other name | <Unavail> |
| Practice address | 1301 33RD ST S, Saint Cloud, MN, 56301 |
| Phone | 3202590000 |
| Fax | 3202590001 |
| Enumeration date | 2006-10-12 |
| Last updated in NPPES | 2025-09-02 |
Authorized official
| Name | Doug Wunderlich |
|---|---|
| Title | Ceo |
| Phone | 3202590000 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 3336C0003X | Community/Retail Pharmacy | Primary | — | — |
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407121841 | Medicaid | MN | — |
Copy-ready billing details
Provider: Southside Pharmacy Ltd NPI: 1669561163 Taxonomy: 3336C0003X (Community/Retail Pharmacy) Address: 1301 33RD ST S, Saint Cloud, MN, 56301
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1013912559 | Kristen Heffern | Individual | Family Nurse Practitioner | Saint Cloud, MN |
| 1215902879 | Eunice Weslander | Individual | Physician Assistant | Saint Cloud, MN |
| 1891730115 | Patrick Zook | Individual | Family Medicine Physician | Saint Cloud, MN |
| 1659316891 | Kimberly Tjaden | Individual | Family Medicine Physician | Saint Cloud, MN |
| 1588691679 | Basil Leblanc | Individual | Family Medicine Physician | St Cloud, MN |
| 1790712388 | Kevin Donnelly | Individual | Family Medicine Physician | St Cloud, MN |
| 1649208091 | Gary Kolle | Individual | Family Medicine Physician | St Cloud, MN |
| 1346278769 | Thomas Wyne | Individual | Family Medicine Physician | Saint Cloud, MN |
Verify this record
Cross-check NPI 1669561163 against the authoritative CMS record: view Southside Pharmacy Ltd on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
What type of organization is Southside Pharmacy Ltd?
What is a Type 2 NPI?
Source: CMS NPPES (public data). Snapshot 2026-07-10. Provider record last updated 2025-09-02.