Provider First Line Business Practice Location Address:
315 S. BROADWAY
Provider Second Line Business Practice Location Address:
BROADWAY DISCOUNT PHARMACY INC
Provider Business Practice Location Address City Name:
CAMDEN
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08103-1208
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
856-963-6333
Provider Business Practice Location Address Fax Number:
856-963-6332
Provider Enumeration Date:
08/12/2014