Organization
NORTHEAST PHARMACEUTICALS INC
Active
Other names
NORTHEAST PHARMACEUTICALS-DOTHAN
Organization subpart
No
Provider details
NPI number
Authorized official
LATONYA PORTER (DIRECTOR OF OPERATIONS)
(334) 356-7627
Entity
Organization
Contact information
Practice address
134 PREVATT RD, DOTHAN, AL 36301-5427
(334) 356-7627
(334) 356-8347
Mailing address
3480 EASTERN BLVD, MONTGOMERY, AL 36116-1700
(334) 356-7627
(334) 356-8347
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
113591
AL
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2129374
PK
—
Enumeration date
03/03/2011
Last updated
07/15/2015
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