Provider First Line Business Practice Location Address: 
740 E STATE STREET
    Provider Second Line Business Practice Location Address: 
PHARMACY
    Provider Business Practice Location Address City Name: 
SHARON
    Provider Business Practice Location Address State Name: 
PA
    Provider Business Practice Location Address Postal Code: 
16146
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
724-983-5640
    Provider Business Practice Location Address Fax Number: 
724-983-3979
    Provider Enumeration Date: 
02/27/2007