| NPI | 1205872686 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANE SANDERS HARVEY Phcy Compliance Mgr Ga 404-949-5336 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336M0003X Pharmacy Managed Care Organization Pharmacy (Licence: GA 07798) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2007-07-19 |