Provider First Line Business Practice Location Address:
300 PRISON RD
Provider Second Line Business Practice Location Address:
FOLSOM STATE PRISON - PHARMACY
Provider Business Practice Location Address City Name:
REPRESA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95671-4071
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
916-985-2561
Provider Business Practice Location Address Fax Number:
916-608-3112
Provider Enumeration Date:
04/24/2012