Healthcare Provider Details

I. General information

NPI: 1215188958
Provider Name (Legal Business Name): DAMAR OF PUERTO SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2008
Last Update Date: 09/19/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 AVE LAS CUMBRES # 199
GUAYNABO PR
00969-5523
US

IV. Provider business mailing address

PO BOX 25130
SAN JUAN PR
00928-5130
US

V. Phone/Fax

Practice location:
  • Phone: 787-790-4312
  • Fax: 787-731-5609
Mailing address:
  • Phone: 787-790-4312
  • Fax: 787-731-5609

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number19-F-2959
License Number StatePR
# 3
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3336M0002X
TaxonomyMail Order Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: ALLAN CAO
Title or Position: ADMINISTRATOR
Credential: PHARM. D
Phone: 786-547-3240