MEDICARE: RETO PHARMACY INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0003X	Community/Retail Pharmacy	11F1290	PR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4021818	OTHER		NCPDP PROVIDER IDENTIFICATION NUMBER

General Provider Information

NPI Number	:	1093720484
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RETO PHARMACY INC

Provider Business Mailing Address
First Line	:	665 CALLE ARISTIDES CHAVIER # G8
Second Line	:	CTRO COMERICAL VILLA PRADES
City	:	SAN JUAN
State	:	PR
Zip	:	00924-2173
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	665 CALLE ARISTIDES CHAVIER # G8
Second Line	:	CTRO COMERICAL VILLA PRADES
City	:	SAN JUAN
State	:	PR
Zip	:	00924-2173
Country	:	US
Telephone Number	:	787-767-2097
Fax Number	:	787-764-9428

Authorized Official
Title or Position	:	OWNER
Name	:	ALEXIS TORRADO
Credential	:
Telephone Number	:	787-767-2097

Provider Enumeration Date	:	07/31/2006
Last Update Date	:	04/28/2009

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Directions to “RETO PHARMACY INC ” Practice Location

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