Healthcare Provider Details

I. General information

NPI: 1023364528
Provider Name (Legal Business Name): PRESCRIPTION HEALTH RESOURCES OF PUERTO RICO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/02/2012
Last Update Date: 07/17/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

A1 CALLE ARPEGIO # 2 HIGHLAND GARDENS
GUAYNABO PR
00969-3519
US

IV. Provider business mailing address

A1 CALLE ARPEGIO # 2 HIGHLAND GARDENS
GUAYNABO PR
00969-3519
US

V. Phone/Fax

Practice location:
  • Phone: 787-545-2073
  • Fax: 787-545-4702
Mailing address:
  • Phone: 787-545-2073
  • Fax: 787-545-4702

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number17F3300
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: NATALIE NEVAREZ
Title or Position: GENERAL MANAGER
Credential:
Phone: 787-545-2073