Healthcare Provider Details

I. General information

NPI: 1366654949
Provider Name (Legal Business Name): SPS SPECIALTY PHARMACY SERVICES,INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2007
Last Update Date: 07/22/2024
Certification Date: 07/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 AVE LUIS MUNOZ MARIN PLAZA NOTRE DAME 5
CAGUAS PR
00725
US

IV. Provider business mailing address

75 AVE LUIS MUNOZ MARIN PLAZA NOTRE DAME 5
CAGUAS PR
00725
US

V. Phone/Fax

Practice location:
  • Phone: 787-704-2025
  • Fax: 787-704-2027
Mailing address:
  • Phone: 787-704-2025
  • Fax: 787-704-2027

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QI0500X
TaxonomyInfusion Therapy Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MRS. ENID SANTIAGO
Title or Position: PHARMACIST
Credential: RPH
Phone: 787-704-2025