Healthcare Provider Details

I. General information

NPI: 1528210572
Provider Name (Legal Business Name): ABSOLUTE PHARMACY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2008
Last Update Date: 10/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

SAN GERMAN MEDICAL PLAZA SUITE 107
SAN GERMAN PR
00683-9340
US

IV. Provider business mailing address

HC 3 BOX 25711
SAN GERMAN PR
00683-9340
US

V. Phone/Fax

Practice location:
  • Phone: 787-892-8700
  • Fax: 787-264-5800
Mailing address:
  • Phone: 787-892-8700
  • Fax: 787-264-5800

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number10-F-2671
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number10-F-2671
License Number StatePR

VIII. Authorized Official

Name: MRS. OMARYS GONZALEZ
Title or Position: PHARMACIST
Credential: RPH
Phone: 787-892-8700