Provider First Line Business Practice Location Address:
383 FD ROOSEVELT AVE
Provider Second Line Business Practice Location Address:
2ND FLOOR PHARMACY DEPARTMENT
Provider Business Practice Location Address City Name:
SAN JUAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00918-2131
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-282-7900
Provider Business Practice Location Address Fax Number:
888-788-2991
Provider Enumeration Date:
11/13/2006