| NPI | 1326028978 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBBIE SELF Controller 706-439-6812 |
| Organization Subpart ? | No |
| Primary Taxonomy | 282NC0060X General Acute Care Hospital Critical Access |
| Additional Taxonomies | 208VP0014X Pain Medicine Interventional Pain Medicine |
| 3336C0004X Pharmacy Compounding Pharmacy | |
| Enumeration Date | 2006-01-19 |
| Last Update Date | 2024-02-15 |