MEDICARE: JORGE L COLON

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	07-F-2029	PR

General Provider Information

NPI Number	:	1346391919
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JORGE L COLON

Provider Business Mailing Address
First Line	:	PO BOX 1851
Second Line	:
City	:	MOCA
State	:	PR
Zip	:	00676-1851
Country	:	US
Telephone Number	:	787-265-5910
Fax Number	:	787-265-2541

Provider Business Practice Location Address
First Line	:	CARR. 64 ( OLD341) KM 3.4 BO MANI
Second Line	:
City	:	MAYAGUEZ
State	:	PR
Zip	:	00680
Country	:	US
Telephone Number	:	787-265-5910
Fax Number	:	787-265-5910

Authorized Official
Title or Position	:	PHARMCIST-OWNER
Name	:	JORGE L COLON
Credential	:
Telephone Number	:	787-265-5910

Provider Enumeration Date	:	01/12/2007
Last Update Date	:	06/09/2026

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