Healthcare Provider Details

I. General information

NPI: 1821075557
Provider Name (Legal Business Name): YAREIMI COLON PHARMACIST
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 12/23/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

URB VILLAS DE JUAN #704 CALLE RIACHUELO
PONCE PR
00716
US

IV. Provider business mailing address

URB VILLAS DE JUAN 704 CALLE RIACHUELO
PONCE PR
00716-3519
US

V. Phone/Fax

Practice location:
  • Phone: 787-290-1953
  • Fax: 787-290-1963
Mailing address:
  • Phone: 787-842-9725
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number4359
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: