| NPI | 1720606080 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VU HOANG Pharmacy Manager 770-723-9460 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Additional Taxonomies | 3336M0002X Pharmacy Mail Order Pharmacy |
| 3336S0011X Pharmacy Specialty Pharmacy | |
| 333600000X Pharmacy | |
| Enumeration Date | 2020-07-13 |
| Last Update Date | 2022-01-13 |