| NPI | 1972977460 |
|---|---|
| Doing Business As | SOUTHEAST PHARMACY |
| Entity Type | Organization |
| Authorized Contact | DANIEL JOHNSON Owner 601-938-5323 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: MS 14553) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2015-11-20 |
| Last Update Date | 2016-03-08 |