| NPI | 1093556193 |
|---|---|
| Doing Business As | SOUTHEAST MEDICINE SHOP |
| Entity Type | Organization |
| Authorized Contact | JOSEPH W DRAKE Outpatient Pharmacy Manager 334-793-8116 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336S0011X Pharmacy, Specialty Pharmacy |
| Enumeration Date | 2024-06-03 |
| Last Update Date | 2024-10-16 |