| NPI | 1417454455 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN MARQUESS Pharm D 770-456-5895 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy Long Term Care Pharmacy (Licence: GA PHRE009933) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2018-04-06 |
| Last Update Date | 2018-04-06 |