| NPI | 1023210044 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES CHARLES HERNDON Pharmacy Manager 706-865-0367 |
| Organization Subpart ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: GA 014565) |
| Enumeration Date | 2007-06-01 |
| Last Update Date | 2007-11-06 |