| NPI | 1467783209 |
|---|---|
| Doing Business As | SOUTHEASTERN MEDICAL COMPOUNDING LLC |
| Entity Type | Organization |
| Authorized Contact | JOHN KENNEDY Vice President 912-201-8138 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0004X Pharmacy, Compounding Pharmacy (Licence: AL 114078) |
| Additional Taxonomies | 3336C0004X Pharmacy, Compounding Pharmacy (Licence: GA PHRE009607) |
| 3336C0004X Pharmacy, Compounding Pharmacy (Licence: MO 2013005924) | |
| 3336C0004X Pharmacy, Compounding Pharmacy (Licence: MI 5301009997) | |
| 3336C0004X Pharmacy, Compounding Pharmacy (Licence: MN 264044) | |
| 3336C0004X Pharmacy, Compounding Pharmacy (Licence: TX 27038) | |
| 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: AZ Y006009) | |
| 3336C0004X Pharmacy, Compounding Pharmacy (Licence: FL PH25026) | |
| 3336C0004X Pharmacy, Compounding Pharmacy (Licence: OH 022297550) | |
| Enumeration Date | 2010-01-19 |
| Last Update Date | 2015-06-11 |