| NPI | 1568761963 |
|---|---|
| Doing Business As | SOUTHEASTERN PHARMACY |
| Entity Type | Organization |
| Authorized Contact | JEFFREY LEE EDGE Pharmacy Supervisor 910-735-8806 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: NC 10389) |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| 3336C0004X Pharmacy, Compounding Pharmacy | |
| 3336H0001X Pharmacy, Home Infusion Therapy Pharmacy | |
| 3336L0003X Pharmacy, Long Term Care Pharmacy | |
| 3336M0002X Pharmacy, Mail Order Pharmacy | |
| 3336M0003X Pharmacy, Managed Care Organization Pharmacy | |
| 3336N0007X Pharmacy, Nuclear Pharmacy | |
| 3336S0011X Pharmacy, Specialty Pharmacy | |
| Enumeration Date | 2011-03-24 |
| Last Update Date | 2013-08-05 |