Southeast Pharmaceuticals, Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

110474 Issued in AL

Legal business name

SOUTHEAST PHARMACEUTICALS, INC

Doing business as

Southeast Pharmaceuticals Vital Care

Practice address

704 Troy Hwy
Ste a
Elba, AL 36323-1521

Phone

(334) 897-3746

Fax

(334) 897-3716

NPI assigned

Aug 30, 2006

Last updated

Jan 29, 2010By 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. John Neal Holley, RPH.NPI 1508343336

Title

President

Phone

(334) 897-3746

Specialties & licenses 11

Addresses

Other identifiers 4

Other names 1

• SOUTHEAST PHARMACEUTICALS VITAL CARE Doing business as

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Southeast Pharmaceuticals, Inc.

  • Oxygen Equipment & Supplies (DME)
  • Elba, AL
  • NPI 1518054816

  O20100930029352

  Same enrollment

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.

• John Neal Holley, RPH.

  • Pharmacist
  • Enterprise, AL
  • NPI 1508343336
  NPD Authorized official

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1264723200000",
    "number": "1427167477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 415",
            "city": "ELBA",
            "state": "AL",
            "postal_code": "363230415",
            "telephone_number": "334-897-3746",
            "fax_number": "334-897-3716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "704 TROY HWY",
            "address_2": "STE A",
            "city": "ELBA",
            "state": "AL",
            "postal_code": "363231521",
            "telephone_number": "334-897-3746",
            "fax_number": "334-897-3716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST PHARMACEUTICALS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2010-01-29",
        "status": "A",
        "authorized_official_last_name": "HOLLEY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "NEAL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "334-897-3746",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "AL",
            "license": "110474",
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "AL",
            "license": "110474",
            "primary": true
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "AL",
            "license": "110474",
            "primary": false
        },
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": "AL",
            "license": "110474",
            "primary": false
        },
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "AL",
            "license": "110474",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "AL",
            "license": "110474",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "AL",
            "license": "110474",
            "primary": false
        },
        {
            "code": "3336H0001X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Home Infusion Therapy Pharmacy",
            "state": "AL",
            "license": "110474",
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "AL",
            "license": "110474",
            "primary": false
        },
        {
            "code": "3336M0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Mail Order Pharmacy",
            "state": "AL",
            "license": "110474",
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "AL",
            "license": "110474",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100002728",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009505350",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "106273500",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS DME",
            "identifier": "510-36152",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SOUTHEAST PHARMACEUTICALS VITAL CARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Noah Tucker Inpatient Services
• Alexis Paige Norris
• Pea River Emergency Physicians
• Catherine Michelle Pope
• Mitchell V Purvis, O,D.
• Southeast Pharmaceuticals, Inc.
• State of Alabama Department of Public Health (Coffee County Health Dept Flu-Pneu)
• Kenneth D. Strong, O.D.
• The Health Care Authority of Elba Alabama (Elba General Hospital)
• The Healthcare Authority of Elba Alabama (Joyce P. Goetsch, MD)

• Durable Medical Equipment & Medical Supplies in Elba, AL
• Providers in Elba, AL by specialty
• Durable Medical Equipment & Medical Supplies in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2010; 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.