| NPI | 1992176648 |
|---|---|
| Doing Business As | MEDICINE MART |
| Entity Type | Organization |
| Authorized Contact | VANCE TIMOTHY WALL CEO 770-294-6620 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 333600000X Pharmacy |
| 3336L0003X Pharmacy, Long Term Care Pharmacy | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2015-10-07 |
| Last Update Date | 2015-10-07 |