Healthcare Provider Details

I. General information

NPI: 1477878270
Provider Name (Legal Business Name): SOUTHEAST SCRIPTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/05/2010
Last Update Date: 04/05/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

413 W MONTGOMERY XRD STE 406
SAVANNAH GA
31406-3396
US

IV. Provider business mailing address

413 W MONTGOMERY XRD STE 406
SAVANNAH GA
31406-3396
US

V. Phone/Fax

Practice location:
  • Phone: 912-233-6811
  • Fax: 912-544-0864
Mailing address:
  • Phone: 912-233-6811
  • Fax: 912-544-0864

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License Number051119
License Number StateGA

VIII. Authorized Official

Name: AMY BOSCH
Title or Position: OFFICE MANAGER
Credential: RN
Phone: 912-233-6811