| NPI | 1821275629 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRUCE J GOULD Medical Director 770-281-5000 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: GA PHRE009445) |
| Additional Taxonomies | 333600000X Pharmacy |
| 3336S0011X Pharmacy, Specialty Pharmacy | |
| Enumeration Date | 2008-01-24 |
| Last Update Date | 2008-02-26 |