| NPI | 1053472910 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STANLEY MIKE RENTZ Director Of Pharmacy 229-242-1925 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: GA PHRE005730) |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: GA PHRE005730) |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2020-08-22 |