| NPI | 1225302904 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGE DOE Owner 202-492-5823 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: GA PHRE009818) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 333600000X Pharmacy | |
| Enumeration Date | 2012-02-28 |
| Last Update Date | 2016-08-31 |