NPI age
19 years
Enumerated 2006-06-07
Across 1965 active pharmacy providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 01 | 1140019 | OTHER ID NUMBER-COMMERCIAL NUMBER |
| 01 | 1140019 | NCPDP |
| 05 (GA) | 00587419A |
Doing-business-as, former, and alternate names recorded by NPPES.
Single-site organization. Only one practice location on file.
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