| NPI | 1225143464 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL SUTTLES HICKS Pharmacy Manager 229-242-3060 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: GA PHRE006491) |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2020-08-22 |