Organization
SOUTHEASTERN PHARMACUETICALS
Active
Other names
CORLEY DRUGS #9
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SCOTT H BURTON RPH (OWNER)
(706) 884-2517
Entity
Organization
Contact information
Practice address
229 DAVIS ROAD, STE 900, LAGRANGE, GA 30241-2546
(706) 298-6870
(706) 298-6875
Mailing address
18 NEW AIRPORT RD, STE B, LAGRANGE, GA 30240-1410
(706) 885-9213
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHRE009416
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
97933748A
—
GA
Enumeration date
11/30/2007
Last updated
11/20/2009
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