| NPI | 1073920476 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ATEEQAHMED S. PATEL Medical Director 770-552-3232 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: GA 39433) |
| Enumeration Date | 2014-07-17 |
| Last Update Date | 2014-07-17 |