Provider First Line Business Practice Location Address:
5905 LAKE EARL DR
Provider Second Line Business Practice Location Address:
PHARMACY DEPARTMENT
Provider Business Practice Location Address City Name:
CRESCENT CITY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95532-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
707-465-1000
Provider Business Practice Location Address Fax Number:
707-465-9178
Provider Enumeration Date:
07/05/2012