| NPI | 1083690911 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HYUNGWON KANG Owner PIC 770-622-0688 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: GA PHRE008994) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2005-12-22 |
| Last Update Date | 2011-06-03 |