| NPI | 1295174407 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL BOGACHEK COO 404-592-0585 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy Long Term Care Pharmacy (Licence: GA PHRE009919) |
| Additional Taxonomies | 3336S0011X Pharmacy Specialty Pharmacy (Licence: GA PHRE009919) |
| Enumeration Date | 2013-06-20 |
| Last Update Date | 2018-12-08 |