Organization
NORTHEAST PHARMACEUTICALS INC
Active
Other names
NORTHEAST PHARMACEUTICALS GADSDEN
Organization subpart
No
Provider details
NPI number
Authorized official
LATONYA PORTER RPH (DIRECTOR OF OPERATIONS)
(334) 356-7627
Entity
Organization
Contact information
Practice address
108 FOUNTAIN AVE, GADSDEN, AL 35901-5652
(256) 413-4455
(256) 413-4477
Mailing address
3480 EASTEN BLVD, MONTGOMERY, AL 36116
(256) 413-4455
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
113079
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1996297
PK
—
Enumeration date
03/26/2008
Last updated
07/15/2015
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