| NPI | 1851721047 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIKE KALBAUGH Credentialing Specialist 336-878-8824 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336H0001X Pharmacy, Home Infusion Therapy Pharmacy (Licence: GA PHRE010124) |
| Enumeration Date | 2013-11-25 |
| Last Update Date | 2023-03-07 |