| NPI | 1568990125 |
|---|---|
| Doing Business As | SOUTHEAST MEDICINE SHOP |
| Entity Type | Organization |
| Authorized Contact | DEREK MILLER CFO 334-793-8111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: AL 114719) |
| Enumeration Date | 2017-05-26 |
| Last Update Date | 2022-07-21 |