NPI age
20 years
Enumerated 2005-06-20
Across 8384 active pharmacist providers in Georgia.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | 5354 | STATE LICENCE # |
| 05 (GA) | 00003166A |
Multi-site organization. 1 additional practice location on file.
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