# SOUTHEAST FOODS, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** COUNTY MARKET PHARMACY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1154459816
- **Authorized official:** CHARLES DEDMON (CFO)
- **Authorized official phone:** (318) 388-1884

## Contact information

- **Practice address:** 3111 HIGHWAY 80 E, PEARL, MS 39208-3503
- **Practice address phone:** (601) 932-5337
- **Practice address fax:** (601) 932-7952
- **Mailing address:** 3111 HIGHWAY 80 E, PEARL, MS 39208-3503
- **Mailing address phone:** (601) 932-5337
- **Mailing address fax:** (601) 932-7952

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | 03618012 | MS | Yes |

## Other

- **Enumeration date:** 03/02/2007
- **Last updated:** 03/02/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 00330610 | — | MS |
| 01 | — | 2520674 | NCPDP PROVIDER IDENTIFICATION NUMBER | — |