Organization
SOUTHEASTERN PHARMACY LLC
Active
Other names
ALTAMA PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
GEORGE MICHAEL LEWIS PHARMD (OWNER/PIC)
(912) 264-2622
Entity
Organization
Contact information
Practice address
5711 ALTAMA AVE STE G, BRUNSWICK, GA 31525-2200
(912) 264-2622
(912) 264-1392
Mailing address
5711 ALTAMA AVE STE G, BRUNSWICK, GA 31525-2200
(912) 264-2622
(912) 264-1392
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
—
—
Other
Enumeration date
07/18/2019
Last updated
07/18/2019
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