Southeast Community Pharmacy

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

SOUTHEAST COMMUNITY PHARMACY

Doing business as

Southeast Community Pharmacy

Practice address

2315 Jefferson Ave
Newport News, VA 23607-4509

Phone

(757) 586-5552

Fax

(757) 586-5558

NPI assigned

Sep 7, 2021

Last updated

Mar 23, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. James Coleman Mitchell Jr., RPHNPI 1275563231

Title

Managing Member

Phone

(757) 586-5552

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Southeast Community Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• James Coleman Mitchell Jr., RPH

  • Pharmacist
  • Newport News, VA
  • NPI 1275563231
  NPD Authorized official

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

{
    "created_epoch": "1630972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679529600000",
    "number": "1336818087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2315 JEFFERSON AVE",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236074509",
            "telephone_number": "757-586-5552",
            "fax_number": "757-586-5558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2315 JEFFERSON AVE",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236074509",
            "telephone_number": "757-586-5552",
            "fax_number": "757-586-5558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST COMMUNITY PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-07",
        "last_updated": "2023-03-23",
        "certification_date": "2023-03-23",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "COLEMAN",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "757-586-5552",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1336818087",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southeast Community Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Southeast Community Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Newport News, VA
• Providers in Newport News, VA by specialty
• Community/Retail Pharmacy in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.