NPI age
19 years
Enumerated 2007-02-20
Across 37 active pharmacy providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 01 | 1152684 | NCPDP NO. |
| 01 (GA) | PHRE008894 | STATE LICENSE NO. |
Doing-business-as, former, and alternate names recorded by NPPES.
Single-site organization. Only one practice location on file.
Subpart of Walgreen Co.
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