| NPI | 1740484179 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOJISOLA EVBUOMWAN Owner 706-323-0306 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: GA PHRE009915) |
| Additional Taxonomies | 3336C0004X Pharmacy Compounding Pharmacy |
| 333600000X Pharmacy | |
| Enumeration Date | 2007-06-11 |
| Last Update Date | 2016-05-04 |