NPI age
10 years
Enumerated 2015-10-08
Across 961 active pharmacy providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 003171959A | |
| 01 | 2155721 | PK |
Doing-business-as, former, and alternate names recorded by NPPES.
Single-site organization. Only one practice location on file.
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