Healthcare Provider Details

I. General information

NPI: 1962552182
Provider Name (Legal Business Name): ONE STOP PRESCRIPTION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/11/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

AVE. MUNOZ RIVERA 1045 MONTE MALL
HATO REY PR
00916
US

IV. Provider business mailing address

730 CALLE JULIO ANDINO
SAN JUAN PR
00924-2252
US

V. Phone/Fax

Practice location:
  • Phone: 787-751-4636
  • Fax:
Mailing address:
  • Phone: 787-751-4636
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number07-F-2330
License Number StatePR

VIII. Authorized Official

Name: PEDRO JULIO VANGA
Title or Position: PRESIDENT
Credential:
Phone: 787-751-4636