Active NPI
Southeastern Pharmacy LLC
- Pharmacy
- Brunswick, GA
National Provider Identifier
1811540867
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- Legal business name
- SOUTHEASTERN PHARMACY LLC
- Practice address
- 5711 Altama Ave Ste G
Brunswick, GA 31525-2200 - Phone
- (912) 264-2622
- Fax
- (912) 264-1392
- NPI assigned
- Jul 18, 2019
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- George Michael Lewis, PHARMD
- Title
- Owner/Pic
- Phone
- (912) 264-2622
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | Primary |
Addresses
Primary practice location
5711 Altama Ave Ste G
Brunswick, GA 31525-2200
Mailing address
5711 Altama Ave Ste G
Brunswick, GA 31525-2200
Phone (912) 264-2622
Other names 1
- ALTAMA PHARMACY
National Provider Directory
National Provider Directory- Tax ID family
- Altama Pharmacy
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Community/Retail Pharmacy
- Brunswick, GA
- NPI 1336165547
Locations
5711 Altama Ave
Ste G
Brunswick, GA 31525
Phone (912) 264-2622
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Pharmacist
- Brunswick, GA
- NPI 1043418973
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1563408000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1563408000000",
"number": "1811540867",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5711 ALTAMA AVE STE G",
"city": "BRUNSWICK",
"state": "GA",
"postal_code": "315252200",
"telephone_number": "912-264-2622",
"fax_number": "912-264-1392"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5711 ALTAMA AVE STE G",
"city": "BRUNSWICK",
"state": "GA",
"postal_code": "315252200",
"telephone_number": "912-264-2622",
"fax_number": "912-264-1392"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SOUTHEASTERN PHARMACY LLC",
"organizational_subpart": "NO",
"enumeration_date": "2019-07-18",
"last_updated": "2019-07-18",
"status": "A",
"authorized_official_last_name": "LEWIS",
"authorized_official_first_name": "GEORGE",
"authorized_official_middle_name": "MICHAEL",
"authorized_official_title_or_position": "OWNER/PIC",
"authorized_official_telephone_number": "912-264-2622",
"authorized_official_credential": "PHARMD"
},
"taxonomies": [
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "ALTAMA PHARMACY",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Brunswick, GA
- Southeastern OB-GYN, P.C.
- Southeastern Pathology Associate
- Southeastern Pathology Associates PC
- Southeastern Pathology Associates PC
- Southeastern Pharmacy LLC
- Southeastern Surgical Associates
- Sadye Souther, D.M.D.
- Southern Coastal ENT PC
- Southern Orthopaedics and Sports Medicine
- Southern Orthopaedics and Sports Medicine, P.C.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.