Provider First Line Business Practice Location Address:
1555 40TH ST
Provider Second Line Business Practice Location Address:
TARGET PHARMACY STORE NUMBER T-2767
Provider Business Practice Location Address City Name:
OAKLAND
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94608-3515
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
510-285-0560
Provider Business Practice Location Address Fax Number:
510-285-0570
Provider Enumeration Date:
12/01/2011