| NPI | 1932217866 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WANDA HICKMAN Owner, AO 770-267-2559 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: GA PHRE004488) |
| Additional Taxonomies | 163WD0400X Registered Nurse, Diabetes Educator |
| 333600000X Pharmacy | |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2019-08-02 |