| NPI | 1578608089 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES STEVEN BROOKS Owner 229-524-2147 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: GA PHRE006773) |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: GA PHRE006773) |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2020-08-22 |