| NPI | 1962423921 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRANT WILSON CEO 706-324-0387 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: GA 008123) |
| Enumeration Date | 2006-07-22 |
| Last Update Date | 2008-02-20 |