| NPI | 1922750462 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA ALLEY Credentialing Specialist 706-722-0705 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site |
| Additional Taxonomies | 1835X0200X Pharmacist, Oncology |
| Enumeration Date | 2022-01-26 |
| Last Update Date | 2022-04-20 |