| NPI | 1528049046 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE W HODGES Controller 229-259-4140 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 333600000X Pharmacy (Licence: GA 008065) |
| 3336S0011X Pharmacy, Specialty Pharmacy | |
| Enumeration Date | 2005-11-10 |
| Last Update Date | 2025-01-31 |