| NPI | 1760229264 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WADE MOORE Owner 706-289-9181 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2024-07-11 |
| Last Update Date | 2024-07-11 |