Southeast Hospital

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

2010038132 Issued in MO

Legal business name

SOUTHEAST HOSPITAL

Practice address

817 S Mount Auburn Rd Ste 130
Cape Girardeau, MO 63703-6392

Phone

(573) 519-4550

Fax

(573) 519-4590

NPI assigned

Nov 3, 2010

Organization subpart

No

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

Authorized official

Name

Krista Berry

Title

Cfo

Phone

(573) 331-6028

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• MERCY PHARMACY S MOUNT AUBURN Doing business as

Locations

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

{
    "created_epoch": "1288742400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709596800000",
    "number": "1982905295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "817 S MOUNT AUBURN RD STE 130",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637036392",
            "telephone_number": "573-519-4550",
            "fax_number": "573-519-4590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "817 S MOUNT AUBURN RD STE 130",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637036392",
            "telephone_number": "573-519-4550",
            "fax_number": "573-519-4590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-03",
        "last_updated": "2024-03-05",
        "certification_date": "2024-03-05",
        "status": "A",
        "authorized_official_last_name": "BERRY",
        "authorized_official_first_name": "KRISTA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "573-331-6028"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MO",
            "license": "2010038132",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2127617",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MERCY PHARMACY S MOUNT AUBURN",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Southeast Hospital
• Southeast Hospital
• Southeast Hospital
• Southeast Hospital
• Southeast Hospital
• Southeast Hospital Based Physicians LLC
• Southeast Missouri Anesthesia Services, LLC
• Southeast Missouri Area Agency on Aging, Inc.
• Southeast Missouri Area Agency on Aging, Inc.
• Southeast Missouri Hospital Physicians LLC

• Community/Retail Pharmacy in Cape Girardeau, MO
• Providers in Cape Girardeau, MO by specialty
• Community/Retail Pharmacy in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 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.