Altama Pharmacy

LBN: Southeastern Pharmacy Llc
Altama Pharmacy is an health care organization with primary practice located at 5711 Altama Ave Unit G, Brunswick GA 31525-2240. The organization recently has only one registered license in Suppliers / Community/Retail Pharmacy, which is considered as the primary health care specialty. Southeastern Pharmacy Llc can be contacted via phone (912) 264-2622, or through Lewis, George Michael via phone (912) 264-2622.

Contact Information

Primary practice address
5711 Altama Ave Unit G Brunswick GA 31525-2240
Phone: (912) 264-2622
Fax: (912) 264-1392
Website:
Map and Directions
Authorized official contact:
Name: Lewis, George Michael
Phone: (912) 264-2622

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Community/Retail Pharmacy 3336C0003X 002733 Georgia

Profile Details

NPI number 1336165547
LBN Legal business name Southeastern Pharmacy Llc
DBA Doing business as Altama Pharmacy
Authorized official Lewis, George Michael
Entity Organization
Organization subpart 1 No
Enumeration date Jul 14th, 2006
Last updated Feb 17th, 2020 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1336165547 NPPES
Georgia MEDICAID 000028256A
Georgia Other 1106930
Georgia MEDICAID 1106930

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