| NPI | 1720031644 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICK DUNHAM Managing Member 770-437-8040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336S0011X Pharmacy, Specialty Pharmacy (Licence: GA PHRE009993) |
| Additional Taxonomies | 333600000X Pharmacy |
| 3336C0003X Pharmacy, Community/Retail Pharmacy | |
| 3336C0004X Pharmacy, Compounding Pharmacy | |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2022-11-17 |