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General NPI Number Information
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NPI Number | 1477878270
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Entity Type | Organization
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Legal Business Name | SOUTHEAST SCRIPTS
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Dates
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Enumeration Date | 04/05/2010
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Last Update Date | 04/05/2010
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Provider Practice Location Address
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Address Line | 413 W MONTGOMERY XRD STE 406
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City | SAVANNAH
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State | GA
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Zip | 31406-3396
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Country | US
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Telephone | 912-233-6811
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Fax | 912-544-0864
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Provider Business Mailing Address
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Address Line | 413 W MONTGOMERY XRD STE 406
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City | SAVANNAH
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State | GA
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Zip | 31406-3396
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Country | US
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Telephone | 912-233-6811
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Fax | 912-544-0864
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | AMY BOSCH
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Credential | RN
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Telephone | 912-233-6811
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332900000X
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Taxonomy Name | Non-Pharmacy Dispensing Site
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License Number | 051119
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License Number State | GA
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