Provider First Line Business Practice Location Address:
3001 GREEN BAY ROAD
Provider Second Line Business Practice Location Address:
DEPT. OF PHARMACY, JAMES A. LOVELL FED. HEALTHCARE CTR.
Provider Business Practice Location Address City Name:
NORTH CHICAGO
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60064
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
224-610-4390
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/08/2012