Southeastern Regional Medical Center Retail Pharmacy

LBN: Southeastern Regional Medical Center, Inc.
Southeastern Regional Medical Center Retail Pharmacy is an health care organization with primary practice located at 600 Celebrate Life Pkwy Ste A176A , Newnan GA 30265-8001. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Southeastern Regional Medical Center, Inc. can be contacted via phone (770) 400-6392, or through Wright, Joel via phone (806) 242-7782.

Contact Information

Primary practice address
600 Celebrate Life Pkwy Ste A176A Newnan GA 30265-8001
Fax: (404) 348-0453
Website:
Authorized official contact:
Name: Wright, Joel

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X

Profile Details

NPI number 1346596574
LBN Legal business name Southeastern Regional Medical Center, Inc.
DBA Doing business as Southeastern Regional Medical Center Retail Pharmacy
Authorized official Wright, Joel
Entity Organization
Organization subpart 1 No
Enumeration date Jul 25th, 2012
Last updated Mar 8th, 2024 - about 2 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 1346596574 NPPES
Georgia MEDICAID 003195531A
Georgia Other 1162661

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