Healthcare Provider Details

I. General information

NPI: 1003949108
Provider Name (Legal Business Name): PUERTO RICO DRUG COMPANY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CALLE SAN FRANCISCO # 157 VIEJO SAN JUAN
SAN JUAN PR
00902-3833
US

IV. Provider business mailing address

PO BOX 9023833
SAN JUAN PR
00902-3833
US

V. Phone/Fax

Practice location:
  • Phone: 787-725-2202
  • Fax: 787-721-2002
Mailing address:
  • Phone: 787-725-2202
  • Fax: 787-721-2002

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number4014320
License Number StatePR

VIII. Authorized Official

Name: MR. ALEJANDRO AMADOR
Title or Position: OWNER
Credential:
Phone: 787-725-2202