NPI age
19 years
Enumerated 2006-09-12
Across 1965 active pharmacy providers in Georgia.
20 individual providers on file at this primary practice address.
| Type | Value | Notes |
|---|---|---|
| 01 | 1141136 | NCPDP PROVIDER IDENTIFICATION NUMBER |
| 05 (GA) | 759295303A |
Doing-business-as, former, and alternate names recorded by NPPES.
Multi-provider organization. 20 individual providers on file at this primary address.
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