NPI | 1114108735 |
---|---|
Entity Type | Organization |
Authorized Contact | KEITH JAMES MATTHEWS Pharmacist In Charge 706-869-9799 |
Organization Subpart ? | No |
Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
Additional Taxonomies | 261QH0100X Clinic/Center, Health Services |
3336C0004X Pharmacy, Compounding Pharmacy | |
332B00000X Durable Medical Equipment & Medical Supplies | |
Enumeration Date | 2007-11-26 |
Last Update Date | 2022-05-02 |