| NPI | 1922476829 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACY WILLIAMS Pharmacy District Manager 229-237-6473 |
| Organization Subpart ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: SC 35822) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: GA 028193) |
| Enumeration Date | 2015-09-09 |
| Last Update Date | 2015-09-09 |