| NPI | 1972085769 |
|---|---|
| Doing Business As | RIVER EDGE BOULEVARD PHARMACY |
| Entity Type | Organization |
| Authorized Contact | JESSICA OAKES Billing Manager 478-803-7809 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: GA PHRE010434) |
| Enumeration Date | 2018-08-29 |
| Last Update Date | 2018-08-29 |