Southeast Pharmaceuticals, Inc
May also be knows as Southeast Pharmaceuticals Vital Care
Legal Business Name
Southeast Pharmaceuticals, Inc
Also Known As
Southeast Pharmaceuticals Vital Care
NPI Number
1427167477
NPI Type
Organization
Enumeration Date
08/30/2006
Specialties
(Taxonomies)Name
Code
3336C0003X
332BC3200X
3336H0001X
3336L0003X
3336M0002X
332BX2000X
332BP3500X
333600000X
3336S0011X
Primary Taxonomy
No
No
No
No
No
No
No
No
No
Licenses
State
Alabama
License Number
110474
Contact
Information
Purpose
Mailing
Location
Address
PO BOX 415
704 TROY HWY
City
Elba
Elba
State
AL
AL
Postal Code
36323-0415
36323-1521
Country
US
US
Telephone Number
(334) 897-3746
(334) 897-3746
Authorized Official
Name
Mr. John Holley
Title or Position
PRESIDENT
Telephone Number
(334) 897-3746
Identifiers
Identifier
100002728
009505350
510-36152
106273500
Identifier State
AL
AL
AL
FL
Identifier Issuer
Unknown
Unknown
BCBS DME
Unknown
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 01/29/2010