Provider First Line Business Practice Location Address:
45 OUTWATER LN
Provider Second Line Business Practice Location Address:
RITE AID PHARMACY
Provider Business Practice Location Address City Name:
GARFIELD
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07026-3859
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
973-772-2937
Provider Business Practice Location Address Fax Number:
973-772-7086
Provider Enumeration Date:
08/13/2010