Provider First Line Business Practice Location Address:
7564-7570 HAVERFORD AVENUE
Provider Second Line Business Practice Location Address:
RITE AID PHARMACY,
Provider Business Practice Location Address City Name:
PHILADELPHIA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19151
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-878-4636
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/18/2010