| NPI | 1609676733 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THERESA USTA Owner 678-691-1375 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy |
| Additional Taxonomies | 3336L0003X Pharmacy, Long Term Care Pharmacy |
| 3336C0004X Pharmacy, Compounding Pharmacy | |
| 3336C0003X Pharmacy, Community/Retail Pharmacy | |
| 3336S0011X Pharmacy, Specialty Pharmacy | |
| Enumeration Date | 2025-03-17 |
| Last Update Date | 2026-01-09 |