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Organization
SOUTHEAST PHARMACEUTICALS, INC.
Active
Organization
SOUTHEAST PHARMACEUTICALS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN NEAL HOLLEY RPH (PRESIDENT)
(334) 897-3746
Entity
Organization
Contact information
Practice address
704 TROY HWY, STE A, ELBA, AL 36323-1521
(334) 897-3746
(334) 897-3716
Mailing address
PO BOX 415, ELBA, AL 36323-0415
(334) 897-3746
(334) 897-3716
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
027146
AL
332BC3200X
Customized Equipment (DME)
027146
AL
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
027146
AL
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
027146
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009505350
—
AL
05
—
106273501
—
FL
01
—
510-36152
BCBS
AL
Enumeration date
10/06/2006
Last updated
11/30/2011
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