| NPI | 1083014369 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DORIS MEHU Vice President 912-777-4847 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336H0001X Pharmacy, Home Infusion Therapy Pharmacy (Licence: GA PHRE010044) |
| Additional Taxonomies | 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies (Licence: GA PHRE010044) |
| 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition (Licence: GA PHRE010044) | |
| Enumeration Date | 2014-08-25 |
| Last Update Date | 2014-08-25 |