| NPI | 1093573602 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACY C ALLIGOOD Accounting Manager 229-435-4571 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy Long Term Care Pharmacy |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2024-03-08 |
| Last Update Date | 2024-03-08 |