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 | 332B00000X Durable Medical Equipment & Medical Supplies |
333600000X Pharmacy | |
3336L0003X Pharmacy Long Term Care Pharmacy | |
Enumeration Date | 2015-10-07 |
Last Update Date | 2015-10-07 |