Southeast Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

14553 Issued in MS

Legal business name

SOUTHEAST PHARMACY LLC

Practice address

2402 Long Creek Road
Meridian, MS 39301

Phone

(601) 483-5600

NPI assigned

Nov 20, 2015

Organization subpart

No

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

Authorized official

Name

Daniel Johnson

Title

Owner

Phone

(601) 938-5323

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Southeast Pharmacy Doing business as

Locations

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

{
    "created_epoch": "1447977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1457395200000",
    "number": "1972977460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6125 ZERO RD",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393018655",
            "telephone_number": "601-483-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2402 LONG CREEK ROAD",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "39301",
            "telephone_number": "601-483-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-20",
        "last_updated": "2016-03-08",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-938-5323"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MS",
            "license": "14553",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2155235",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southeast Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sara B Smith
• Sherren Smith, RN-BSN NURSE
• Tracy Smith
• Gabe Snow, PT
• James A. Snyder, D.O.
• Southeastern Anesthesia Services LLC
• Southeastern Medical Supply
• Southern Family Markets LLC
• Southern Home Care Agency LLC
• Southern Home Private Care LLC

• Community/Retail Pharmacy in Meridian, MS
• Providers in Meridian, MS by specialty
• Community/Retail Pharmacy in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2016; 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.