Provider First Line Business Practice Location Address:
700 1ST NORTH ST
Provider Second Line Business Practice Location Address:
ATTN: PHARMACY MANAGER
Provider Business Practice Location Address City Name:
SYRACUSE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
13208-2180
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
315-476-9954
Provider Business Practice Location Address Fax Number:
315-471-0006
Provider Enumeration Date:
12/01/2005