Provider First Line Business Practice Location Address:
1901 JOHNSTON ST
Provider Second Line Business Practice Location Address:
ACME PHARMACY 7715
Provider Business Practice Location Address City Name:
PHILA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19145-4720
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-336-2307
Provider Business Practice Location Address Fax Number:
215-336-2311
Provider Enumeration Date:
03/29/2016