Healthcare Provider Details

I. General information

NPI: 1386665131
Provider Name (Legal Business Name): YANDRO INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2006
Last Update Date: 04/24/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1320 AVE SAN ALFONSO
SAN JUAN PR
00921-3621
US

IV. Provider business mailing address

1320 AVE SAN ALFONSO
SAN JUAN PR
00921-3621
US

V. Phone/Fax

Practice location:
  • Phone: 787-782-6403
  • Fax: 787-782-0630
Mailing address:
  • Phone: 787-782-6403
  • Fax: 787-782-0630

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number19F1456
License Number StatePR

VIII. Authorized Official

Name: ALEJANDRO REYES SANTIAGO
Title or Position: PRESIDENT
Credential:
Phone: 787-782-6403