| NPI | 1902990054 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LOUIS VUONG CFO 770-717-8872 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: GA PHRE008622) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 3336L0003X Pharmacy, Long Term Care Pharmacy | |
| 333600000X Pharmacy | |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2007-08-31 |