| NPI | 1124854922 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHRYN DUPHILY Operations Manager 678-997-9895 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336M0003X Pharmacy Managed Care Organization Pharmacy |
| Enumeration Date | 2024-09-10 |
| Last Update Date | 2024-09-10 |