| NPI | 1780992750 |
|---|---|
| Former Legal Business Name | N/A |
| Entity Type | Organization |
| Authorized Contact | MICHAEL O MADU Pharmacist 678-508-2178 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: MI 5301009423) |
| Enumeration Date | 2010-09-23 |
| Last Update Date | 2010-09-23 |