| NPI | 1477878270 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY BOSCH Office Manager 912-233-6811 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: GA 051119) |
| Enumeration Date | 2010-04-05 |
| Last Update Date | 2010-04-05 |