| NPI | 1710548664 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ITZELIS GODREAU Manager 912-332-2794 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 3336C0004X Pharmacy, Compounding Pharmacy |
| Enumeration Date | 2019-06-21 |
| Last Update Date | 2020-03-25 |