Provider First Line Business Practice Location Address:
724 OLD BETHPAGE RD.
Provider Second Line Business Practice Location Address:
DIAMOND DRUGS II, INC.
Provider Business Practice Location Address City Name:
OLD BETHPAGE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11804
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
516-586-8733
Provider Business Practice Location Address Fax Number:
516-586-8735
Provider Enumeration Date:
01/07/2014