Organization
CORLEY & MCCLENDON, INC
Active
Parent organization
SOUTHEASTERN PHARMACEUTICALS, INC.
Other names
CORLEY DRUGS #3
Organization subpart
Yes
Provider details
NPI number
Legal business name
SOUTHEASTERN PHARMACEUTICALS, INC.
Authorized official
MR. JAMES DAVID COCHRAN RPH (OWNER/PHARMACIST)
(706) 884-2661
Entity
Organization
Contact information
Practice address
820 NORTH GREENWOOD STREET, LAGRANGE, GA 30240
(706) 882-4960
(706) 882-1149
Mailing address
18 NEW AIRPORT ROAD, SUITE B, LAGRANGE, GA 30240
(706) 885-9213
(706) 885-9829
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
PHRE006331
GA
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00290364A
—
GA
01
—
1128479
OTHER ID NUMBER-COMMERCIAL NUMBER
—
01
—
1205855129
NPI
GA
Enumeration date
07/19/2006
Last updated
04/29/2009
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