Healthcare Provider Details

I. General information

NPI: 1386947224
Provider Name (Legal Business Name): PCS PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2010
Last Update Date: 07/06/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

880 BOULEVARD TITO CASTRO ONE PLAZA SUITE 205
PONCE PR
00716
US

IV. Provider business mailing address

880 BOULEVARD TITO CASTRO ONE PLAZA SUITE 205
PONCE PR
00716
US

V. Phone/Fax

Practice location:
  • Phone: 787-843-4545
  • Fax: 787-841-0782
Mailing address:
  • Phone: 787-843-4545
  • Fax: 787-841-0782

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number18F3040
License Number StatePR

VIII. Authorized Official

Name: PATRICIA COSTAS
Title or Position: PRESIDENT/PHARMACIST
Credential:
Phone: 787-843-4545