Provider First Line Business Practice Location Address:
MERITCARE BROADWAY PHARMACY
Provider Second Line Business Practice Location Address:
737 BROADWAY
Provider Business Practice Location Address City Name:
FARGO
Provider Business Practice Location Address State Name:
ND
Provider Business Practice Location Address Postal Code:
58102
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
701-234-2348
Provider Business Practice Location Address Fax Number:
701-234-2433
Provider Enumeration Date:
10/22/2007