NPI age
19 years
Enumerated 2006-09-21
Across 321 active pharmacy providers in Georgia.
1 individual provider on file at this primary practice address.
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 00399022A | |
| 01 | 1108162 | OTHER ID NUMBER-COMMERCIAL NUMBER |
Multi-provider organization. 1 individual provider on file at this primary address.
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