| NPI | 1972000917 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN MARQUESS Owner 770-973-7600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy Long Term Care Pharmacy (Licence: GA PHRE007888) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2018-04-06 |
| Last Update Date | 2018-04-06 |