Healthcare Provider Details

I. General information

NPI: 1962528505
Provider Name (Legal Business Name): LA PAZ PHARMACY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2007
Last Update Date: 06/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARRETERA #2 KM 62.7 SECTOR CANDELARIA
SABANA HOYOS PR
00688
US

IV. Provider business mailing address

152 JOSE RODRIGUEZ IRIZARRY AVE.
ARECIBO PR
00612
US

V. Phone/Fax

Practice location:
  • Phone: 787-881-2440
  • Fax: 787-880-3258
Mailing address:
  • Phone: 787-881-2440
  • Fax: 787-880-3258

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number09-F-2302
License Number StatePR

VIII. Authorized Official

Name: MRS. VIVIAN C BATISTA
Title or Position: MANAGER
Credential:
Phone: 787-881-2440