Provider First Line Business Practice Location Address:
3300 S OATES ST
Provider Second Line Business Practice Location Address:
ATTN PHARMACY
Provider Business Practice Location Address City Name:
DOTHAN
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
36301-5694
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
334-702-0840
Provider Business Practice Location Address Fax Number:
334-702-0580
Provider Enumeration Date:
02/14/2007