| NPI | 1609814219 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARAH E LANG CEO 706-322-9599 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2006-06-04 |
| Last Update Date | 2018-07-03 |