| NPI | 1346589983 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN ANDREW NICHOLS Pharmacist In Charge 706-782-0482 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336C0004X Pharmacy, Compounding Pharmacy (Licence: GA PHRE009854) |
| Enumeration Date | 2013-02-01 |
| Last Update Date | 2013-02-01 |