| NPI | 1851409494 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES CHARLES HERNDON Pharmacy Manager 678-450-9993 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2020-08-22 |