Healthcare Provider Details

I. General information

NPI: 1356642292
Provider Name (Legal Business Name): ONE STOP PRESCRIPTION GUAYNABO INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2010
Last Update Date: 05/03/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CALLE ESMERALDA ESQ. CALLE D SUPERMAX PLAZA GUAYNABO
GUAYNABO PR
00969
US

IV. Provider business mailing address

730 CALLE JULIO ANDINO
SAN JUAN PR
00924-2252
US

V. Phone/Fax

Practice location:
  • Phone: 787-708-3800
  • Fax: 787-708-3700
Mailing address:
  • Phone: 787-751-9606
  • Fax: 787-751-0286

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 Number12-F-2899
License Number StatePR

VIII. Authorized Official

Name: PEDRO VANGA FELICIANO
Title or Position: PRESIDENT
Credential:
Phone: 787-710-6495