| NPI | 1306834874 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DECHANE LEE CAMERON Director 404-289-4088 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy (Licence: GA PHHH000041) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: GA 20015628522) |
| Enumeration Date | 2005-10-10 |
| Last Update Date | 2010-03-17 |