Provider First Line Business Practice Location Address:
324 PATTON STREET
Provider Second Line Business Practice Location Address:
MEDITHRIFT PHARMACY
Provider Business Practice Location Address City Name:
LA FAYETTE
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30728
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
706-638-3114
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/23/2007