Provider First Line Business Practice Location Address:
217 SOUTH THIRD STREET
Provider Second Line Business Practice Location Address:
OUTPATIENT PHARMACY
Provider Business Practice Location Address City Name:
DANVILLE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40422
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
859-239-1706
Provider Business Practice Location Address Fax Number:
859-239-6759
Provider Enumeration Date:
10/27/2006