| NPI | 1285787705 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADLEY BENTON PIERCY Mgr 770-939-4333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: GA PHRE006480) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: GA RPH015404) |
| Enumeration Date | 2007-01-19 |
| Last Update Date | 2007-08-02 |