NPI age
17 years
Enumerated 2008-09-04
Across 961 active pharmacy providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 035177612A | |
| 01 (GA) | 035177612B | MEDICAID DME |
| 01 | 1157747 | NCPDP |
Doing-business-as, former, and alternate names recorded by NPPES.
Single-site organization. Only one practice location on file.
Subpart of Walgreens Boots Alliance Inc.
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