NPI | 1013465236 |
---|---|
Former Legal Business Name | PREMIER SPECIALTY PHARMACY |
Entity Type | Organization |
Authorized Contact | BUFFY GOUGELMANN Pharmacist In Charge 770-622-8901 |
Organization Subpart ? | No |
Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: GA PHRE010313) |
Additional Taxonomies | 333600000X Pharmacy |
3336C0004X Pharmacy, Compounding Pharmacy | |
Enumeration Date | 2016-09-16 |
Last Update Date | 2017-02-21 |