NPIMap

Organization Active NPI

Houston County Healthcare Authority

Doing business as Southeast Medicine Shop

  • Community/Retail Pharmacy
  • Dothan, AL
National Provider Identifier
1568990125
Registry record updated Nov 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
114719 Issued in AL
Legal business name
HOUSTON COUNTY HEALTHCARE AUTHORITY
Doing business as
Southeast Medicine Shop
Practice address
1108 Ross Clark Cir Ste 160
Dothan, AL 36301-3022
Phone
(334) 793-8116
Fax
(334) 712-3701
NPI assigned
May 26, 2017
Last updated
Nov 12, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2024

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

Authorized official

Name
Joseph W Drake, PHARMD
Title
Outpatient Pharmacy Manager
Phone
(334) 793-8116

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 114719 AL Primary

Addresses

Primary practice location

1108 Ross Clark Cir Ste 160
Dothan, AL 36301-3022

Mailing address

1108 Ross Clark Cir Ste 160
Dothan, AL 36301-3022
Phone (334) 793-8116

Other names 1

  • Southeast Medicine Shop Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Houston Coenterprise Med17 organizations share this tax ID, including this one

Other organizations with this tax ID 16

Organizations that report the same tax identification number in the National Provider Directory.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1495756800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731369600000",
    "number": "1568990125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1108 ROSS CLARK CIR STE 160",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363013022",
            "telephone_number": "334-793-8116",
            "fax_number": "334-712-3701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1108 ROSS CLARK CIR STE 160",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363013022",
            "telephone_number": "334-793-8116",
            "fax_number": "334-712-3701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOUSTON COUNTY HEALTHCARE AUTHORITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-26",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A",
        "authorized_official_last_name": "DRAKE",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OUTPATIENT PHARMACY MANAGER",
        "authorized_official_telephone_number": "334-793-8116",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "AL",
            "license": "114719",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southeast Medicine Shop",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dothan, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2024; 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.