Healthcare Provider Details

I. General information

NPI: 1093886087
Provider Name (Legal Business Name): CO-PHARMA INTEGRATED SOLUTIONS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/13/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ZONA LIBRE COMERCIO CENTRO CIBERNETICO CARR 165
GUAYNABO PR
00965
US

IV. Provider business mailing address

PO BOX 195496
SAN JUAN PR
00919-5496
US

V. Phone/Fax

Practice location:
  • Phone: 787-627-2476
  • Fax: 787-622-7311
Mailing address:
  • Phone: 787-627-2476
  • Fax: 787-622-7311

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License Number
License Number State

VIII. Authorized Official

Name: MR. CARLOS HIRAM COLLAZO
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 787-627-2476