| NPI | 1659346542 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VANCE WALL President And CEO 678-689-2388 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: SC 9181) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 333600000X Pharmacy | |
| 3336L0003X Pharmacy, Long Term Care Pharmacy | |
| Enumeration Date | 2006-02-22 |
| Last Update Date | 2018-04-11 |