| NPI | 1679602452 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN CARR Owner 770-934-2976 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy Long Term Care Pharmacy |
| Additional Taxonomies | 3336C0004X Pharmacy Compounding Pharmacy |
| 3336I0012X Pharmacy Institutional Pharmacy (Licence: GA PHRE007383) | |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2019-11-19 |