# SOUTHEASTERN MEDICAL SUPPLY INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1578568176
- **Authorized official:** ELEANOR MARIE METHOT (PRESIDENT)
- **Authorized official phone:** (863) 965-8856

## Contact information

- **Practice address:** 3615 CENTURY BLVD, UNIT \#1, LAKELAND, FL 33811
- **Practice address phone:** (863) 965-8856
- **Practice address fax:** (863) 551-1777
- **Mailing address:** 3615 CENTURY BLVD, UNIT \#1, LAKELAND, FL 33811
- **Mailing address phone:** (863) 965-8856
- **Mailing address fax:** (863) 551-1777

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | Yes |

## Other

- **Enumeration date:** 06/20/2005
- **Last updated:** 06/28/2016