Healthcare Provider Details

I. General information

NPI: 1306071568
Provider Name (Legal Business Name): ZAGA PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2009
Last Update Date: 03/07/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR. #931 KM. 5.3 PRADERAS SHOPPING CENTER
GURABO PR
00778
US

IV. Provider business mailing address

1727 AVE JESUS T PINERO
SAN JUAN PR
00920-5408
US

V. Phone/Fax

Practice location:
  • Phone: 787-687-2566
  • Fax: 787-687-7941
Mailing address:
  • Phone: 787-479-0284
  • Fax: 787-781-1734

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number17-F-2722
License Number StatePR

VIII. Authorized Official

Name: ANGEL AREIZAGA
Title or Position: PRESIDENT
Credential:
Phone: 787-479-0284