Provider First Line Business Practice Location Address:
BOX 2000, HEALTH SCIENCES BUILDING SCHOOL OF PHARMACY
Provider Second Line Business Practice Location Address:
SOUTHERN ILLINOIS UNIVERSITY EDWARDSVILLE
Provider Business Practice Location Address City Name:
EDWARDSVILLE
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
62026-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-381-5420
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/13/2026