Provider First Line Business Practice Location Address:
POB 146 47 STEWART AVENUE
Provider Second Line Business Practice Location Address:
MEDICINE SHOPPE PHARMACY
Provider Business Practice Location Address City Name:
ROSCOE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12776
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
607-498-4111
Provider Business Practice Location Address Fax Number:
607-498-4117
Provider Enumeration Date:
12/18/2007