| NPI | 1891534400 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HIBA TAKI Manager 770-274-6655 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 3336M0003X Pharmacy, Managed Care Organization Pharmacy |
| Enumeration Date | 2024-05-22 |
| Last Update Date | 2025-08-11 |