Seaside Pharmaceutical Inc

Primary specialty

PharmacistTaxonomy code 183500000X

License

RPH020213 Issued in GA

Legal business name

SEASIDE PHARMACEUTICAL INC

Practice address

1104 Fountain Park Circle
Brunswick, GA 31520-4758

Phone

(912) 554-8220

Fax

(912) 554-8221

NPI assigned

May 28, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Robert Stanley Trethaway, PHARMACIST

Title

Owner/Ceo

Phone

(912) 554-8220

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1225085889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1104 FOUNTAIN PARK CIRCLE",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315204758",
            "telephone_number": "912-554-8220",
            "fax_number": "912-554-8221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1104 FOUNTAIN PARK CIRCLE",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315204758",
            "telephone_number": "912-554-8220",
            "fax_number": "912-554-8221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEASIDE PHARMACEUTICAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-28",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "TRETHAWAY",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "STANLEY",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "912-554-8220",
        "authorized_official_credential": "PHARMACIST"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "RPH020213",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OCCUPATIONAL TAX LICENSE",
            "identifier": "11639",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACY LICENSE",
            "identifier": "PHHH000002",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "407152969A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sea Pines Oral and Facial Surgery, PC
• John Mark Seacat, O.D.
• Eric Devon Seals, LAPC
• Sears Nursing Home, LLC
• Seaside Ophthalmology, Inc
• Seaside Surgical, LLC
• Daniel Edward Seay, MD
• Eric C Segerberg, M.D
• Marjorie Sen, PHARM.D.
• Serena Skinner Aprn PC

• Pharmacist in Brunswick, GA
• Providers in Brunswick, GA by specialty
• Pharmacist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.