Healthcare Provider Details

I. General information

NPI: 1588658611
Provider Name (Legal Business Name): LC PHARMA-TECK INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/04/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1644 CALLE PARANA URB. EL CEREZAL
SAN JUAN PR
00926-3145
US

IV. Provider business mailing address

PO BOX 366263
SAN JUAN PR
00936-6263
US

V. Phone/Fax

Practice location:
  • Phone: 787-758-6333
  • Fax: 787-751-7439
Mailing address:
  • Phone: 787-758-6333
  • Fax: 787-751-7439

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number07-F-2201
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code332BN1400X
TaxonomyNursing Facility Supplies (DME)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number07-F-2201
License Number StatePR
# 5
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number07-F-2201
License Number StatePR
# 6
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number07-F-2201
License Number StatePR
# 7
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: LUIS V CLAS
Title or Position: PRESIDENT
Credential:
Phone: 787-758-6333