| NPI | 1508538679 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICK TULLY Chief Pharmacist 912-427-0870 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QP2400X Clinic/Center, Prison Health |
| Additional Taxonomies | 3336C0002X Pharmacy, Clinic Pharmacy |
| Enumeration Date | 2021-09-28 |
| Last Update Date | 2021-09-28 |