Provider First Line Business Practice Location Address:
200 E. 167 STREET
Provider Second Line Business Practice Location Address:
LUMIT PHARMACY
Provider Business Practice Location Address City Name:
BRONX
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10456
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-866-0629
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/21/2007