| NPI | 1093116394 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANTERRICA CHERELLE LUCKETT Pharmacist 912-247-6784 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: SC 35733) |
| Enumeration Date | 2014-09-06 |
| Last Update Date | 2014-09-06 |