Provider First Line Business Practice Location Address:
1000 EAST EAGER STREET
Provider Second Line Business Practice Location Address:
RITEAID PHARMACY
Provider Business Practice Location Address City Name:
BALTIMORE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21202-3258
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-502-8414
Provider Business Practice Location Address Fax Number:
410-522-9886
Provider Enumeration Date:
03/13/2007