| NPI | 1619044914 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM GRADY CAGLE Owner 770-479-5533 |
| Organization Subpart ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: GA 8181) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: 332B00000X) |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2008-07-19 |