Provider First Line Business Practice Location Address:
2433 HIGHWAY #34
Provider Second Line Business Practice Location Address:
SHOPRITE PHARMACY
Provider Business Practice Location Address City Name:
MANASQUAN
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08736
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
732-528-8161
Provider Business Practice Location Address Fax Number:
732-528-0507
Provider Enumeration Date:
12/22/2011