Provider First Line Business Practice Location Address:
231 PROSPECT ST
Provider Second Line Business Practice Location Address:
PHARMACY DEPT
Provider Business Practice Location Address City Name:
SOUTH RIVER
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08882-1124
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
732-254-7777
Provider Business Practice Location Address Fax Number:
732-254-1124
Provider Enumeration Date:
07/15/2010