| NPI | 1598040560 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHANDLER MARSHALL CONNER CEO/PIC 706-521-0272 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336H0001X Pharmacy, Home Infusion Therapy Pharmacy (Licence: GA PHRE009782) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: GA PHRE009782) |
| 3336S0011X Pharmacy, Specialty Pharmacy (Licence: GA PHRE009782) | |
| Enumeration Date | 2011-10-20 |
| Last Update Date | 2015-08-10 |