Provider First Line Business Practice Location Address:
150 MINERAL SPRING AVE
Provider Second Line Business Practice Location Address:
(RITE AID PHARMACY)
Provider Business Practice Location Address City Name:
PAWTUCKET
Provider Business Practice Location Address State Name:
RI
Provider Business Practice Location Address Postal Code:
02860
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
401-726-0547
Provider Business Practice Location Address Fax Number:
401-726-8573
Provider Enumeration Date:
08/19/2011