| NPI | 1417252818 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PRICE WALKER CEO 706-322-6890 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: GA 021065) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: GA 021065) |
| Enumeration Date | 2011-01-14 |
| Last Update Date | 2011-01-14 |