| NPI | 1275548919 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HAGGAI N TUMBAN Pharmacist In Charge President 678-701-0383 |
| Organization Subpart ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: GA RPH019783) |
| Additional Taxonomies | 333600000X Pharmacy (Licence: GA PHRE008685) |
| Enumeration Date | 2006-07-30 |
| Last Update Date | 2020-08-22 |