Healthcare Provider Details
I. General information
NPI: 1295899326
Provider Name (Legal Business Name): PMC MARKETING CORP
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/21/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
FACTORY OULETETS CARR # 2 BO FLORIDA
BARCELONETA PR
00617
US
IV. Provider business mailing address
PO BOX 29166
SAN JUAN PR
00929-0166
US
V. Phone/Fax
- Phone: 787-970-3640
- Fax: 787-970-3644
- Phone: 787-641-3888
- Fax: 787-756-0160
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | |
| License Number State | |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name: DR.
SULTAN
SALEH
YASSIN
Title or Position: VICE PRESIDENT
Credential: PHARM D
Phone: 787-641-3888