| NPI | 1215296470 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VINCENT HARVILLE Mgr 770-672-7976 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: GA PHHH000051) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 333600000X Pharmacy | |
| 3336C0004X Pharmacy Compounding Pharmacy | |
| 3336H0001X Pharmacy Home Infusion Therapy Pharmacy | |
| 3336L0003X Pharmacy Long Term Care Pharmacy | |
| 3336S0011X Pharmacy Specialty Pharmacy | |
| Enumeration Date | 2012-05-09 |
| Last Update Date | 2012-05-09 |