Provider First Line Business Practice Location Address:
509 MEMORIAL DRIVE SUITE 1
Provider Second Line Business Practice Location Address:
MEDI CENTER DRUGS, INC.
Provider Business Practice Location Address City Name:
MANCHESTER
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40962
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
606-598-7933
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/21/2006