| NPI | 1770865248 |
|---|---|
| Doing Business As | WELLSTAR PHARMACY NETWORK STORE #4 |
| Entity Type | Organization |
| Authorized Contact | T. MARK HANEY Site Administrator 770-445-4411 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: GA PHRE009764) |
| Enumeration Date | 2011-09-12 |
| Last Update Date | 2011-09-12 |