Healthcare Provider Details

I. General information

NPI: 1043498991
Provider Name (Legal Business Name): HEALTH MART PHARMACY PLUS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/02/2008
Last Update Date: 11/11/2025
Certification Date: 11/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

615 CALLE DR.MANUEL PAVIA SANTURCE
SAN JUAN PR
00908
US

IV. Provider business mailing address

PO BOX 9300461
SAN JUAN PR
00928-5861
US

V. Phone/Fax

Practice location:
  • Phone: 787-722-3600
  • Fax: 787-722-6555
Mailing address:
  • Phone: 787-421-9700
  • Fax: 787-722-6555

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number09-F-2564
License Number StatePR

VIII. Authorized Official

Name: MR. ABDEL H SABRI SHIHADEH
Title or Position: PRESIDENT
Credential:
Phone: 787-373-7224