NPI age
13 years
Enumerated 2012-06-18
Across 8384 active pharmacist providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 000323232A | |
| 05 (GA) | 003125807A |
Part of a multi-provider practice. 2 other active providers share this practice address in NPPES.
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