Provider First Line Business Practice Location Address:
REALO DISCOUNT DRUGS, 423 YOPP RD,
Provider Second Line Business Practice Location Address:
STE 200
Provider Business Practice Location Address City Name:
JACKSONVILLE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28540
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
910-347-9684
Provider Business Practice Location Address Fax Number:
910-455-0622
Provider Enumeration Date:
05/19/2008