Provider First Line Business Practice Location Address:
501 W 113TH ST
Provider Second Line Business Practice Location Address:
TOWN DRUG PHARAMACY
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10025-8073
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-678-0636
Provider Business Practice Location Address Fax Number:
212-662-3148
Provider Enumeration Date:
05/06/2008