| NPI | 1316465859 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHIBUGO EJISOBY-NWOSU Pharmacist Consultant/ Director 678-576-4708 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336M0003X Pharmacy, Managed Care Organization Pharmacy |
| Enumeration Date | 2017-09-05 |
| Last Update Date | 2022-07-21 |