| NPI | 1205876950 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY SEAGRAVES PIC 706-433-0246 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: GA PHHH000015) |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2020-08-22 |