| NPI | 1730500281 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONY RAYFUS President 678-439-6789 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 332900000X Non-Pharmacy Dispensing Site (Licence: AL 194955) |
| 333600000X Pharmacy (Licence: GA PWHW003864) | |
| Enumeration Date | 2013-12-31 |
| Last Update Date | 2015-11-02 |