| NPI | 1063669315 |
|---|---|
| Doing Business As | MEDICAL CENTER WEST COMPDING LAB |
| Entity Type | Organization |
| Authorized Contact | KYLE W PULLIAM Pharmacist 706-855-5502 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0004X Pharmacy, Compounding Pharmacy (Licence: GA PHRE009484) |
| Enumeration Date | 2008-08-19 |
| Last Update Date | 2008-08-19 |