| NPI | 1053123703 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DHARMESH PATEL Officer In Charge Of Licensing 770-864-5998 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336M0002X Pharmacy, Mail Order Pharmacy |
| Enumeration Date | 2025-01-21 |
| Last Update Date | 2025-01-21 |