Provider First Line Business Practice Location Address:
1199 AMBOY AVENUE
Provider Second Line Business Practice Location Address:
RITE AID PHARMACY
Provider Business Practice Location Address City Name:
EDISON
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08837
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
732-494-0677
Provider Business Practice Location Address Fax Number:
732-452-0523
Provider Enumeration Date:
07/10/2010