NPI age
19 years
Enumerated 2006-11-15
Across 1965 active pharmacy providers in Georgia.
1 individual provider on file at this primary practice address.
| Type | Value | Notes |
|---|---|---|
| 01 | 1128405 | OTHER ID NUMBER-COMMERCIAL NUMBER |
| 05 (GA) | 00289264A |
Doing-business-as, former, and alternate names recorded by NPPES.
Multi-provider organization. 1 individual provider on file at this primary address.
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