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 |