Healthcare Provider Details

I. General information

NPI: 1932110053
Provider Name (Legal Business Name): HEALTH ADMIN SVC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2006
Last Update Date: 01/09/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR 592 NUM 15 BO AMUELAS
JUANA DIAZ PR
00795-2872
US

IV. Provider business mailing address

PO BOX 194288
SAN JUAN PR
00919-4288
US

V. Phone/Fax

Practice location:
  • Phone: 787-837-6574
  • Fax: 787-260-0034
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number07F2156
License Number StatePR
# 3
Primary TaxonomyN
Taxonomy Code3336I0012X
TaxonomyInstitutional Pharmacy
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: JERGE PAOLI BRUNO
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 787-381-0247