Provider First Line Business Practice Location Address:
2015 E NEWPORT AVENUE, M121
Provider Second Line Business Practice Location Address:
CSM COMMUNITY PHARMACIES
Provider Business Practice Location Address City Name:
MILWAUKEE
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
53211
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
414-961-3581
Provider Business Practice Location Address Fax Number:
414-961-5378
Provider Enumeration Date:
11/13/2006