Provider First Line Business Practice Location Address:
165 ERIE ST
Provider Second Line Business Practice Location Address:
NEWPORT PHARMACY
Provider Business Practice Location Address City Name:
JERSEY CITY
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07302-1717
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
201-963-1903
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/20/2014