| NPI | 1013618511 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMMAR TANK Member 678-977-9009 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2023-03-13 |
| Last Update Date | 2025-02-26 |