| NPI | 1720654619 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SMIKAL J PATEL Pharmacy Manager 770-723-9460 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy Long Term Care Pharmacy |
| Additional Taxonomies | 3336M0002X Pharmacy Mail Order Pharmacy |
| Enumeration Date | 2021-06-01 |
| Last Update Date | 2022-01-13 |