| NPI | 1780808535 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUDITH WAGNER Pharmacist In Charge 404-524-4466 |
| Organization Subpart ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: GA phre005725) |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2007-11-28 |