Healthcare Provider Details
I. General information
NPI: 1629128913
Provider Name (Legal Business Name): GNS AGRONT INC
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
33 CALLE MUNOZ RIVERA W
RINCON PR
00677-2124
US
IV. Provider business mailing address
33 CALLE MUNOZ RIVERA W
RINCON PR
00677-2124
US
V. Phone/Fax
- Phone: 787-823-2540
- Fax: 787-823-3183
- Phone: 787-823-2540
- Fax: 787-823-3183
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | 07-F-1079 |
| License Number State | PR |
VIII. Authorized Official
Name:
NICASIO
AGRONT
Title or Position: PRESIDENT
Credential:
Phone: 787-823-2540