| NPI | 1992861884 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SONYA BROUSSARD PIC/Owner 678-595-7531 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy Long Term Care Pharmacy (Licence: GA PHRE009109) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2025-02-25 |