Healthcare Provider Details

I. General information

NPI: 1780119321
Provider Name (Legal Business Name): PHARMA ANA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2017
Last Update Date: 04/20/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HIDALGO 244 INT #10
CHAPALA JALISCO
45922
MX

IV. Provider business mailing address

HIDALGO 244 INT #10
CHAPALA JALISCO
45922
MX

V. Phone/Fax

Practice location:
  • Phone: 18884497799
  • Fax: 415-484-7275
Mailing address:
  • Phone: 18884497799
  • Fax: 415-484-7275

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State

VIII. Authorized Official

Name: MISS ANA RENTERIA
Title or Position: OWNER-MANAGER
Credential: MBA
Phone: 18884497799