Provider Demographics
NPI:1578169033
Name:SOUTHEAST OHIO FREE PHARMACY
Entity Type:Organization
Organization Name:SOUTHEAST OHIO FREE PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST / BOARD PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:ADKINS
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED PHARMACIS
Authorized Official - Phone:614-849-2971
Mailing Address - Street 1:PO BOX 193
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:OH
Mailing Address - Zip Code:45701-0193
Mailing Address - Country:US
Mailing Address - Phone:614-849-2971
Mailing Address - Fax:
Practice Address - Street 1:86 COLUMBUS CIR STE 104G
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:OH
Practice Address - Zip Code:45701-1371
Practice Address - Country:US
Practice Address - Phone:614-849-2971
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-09
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy