Healthcare Provider Details

I. General information

NPI: 1417188244
Provider Name (Legal Business Name): CENTRAL DRUG DORADO. CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2009
Last Update Date: 06/11/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARRETERA 1 KM 25.5 SECTOR LOS NAVARROS BO QUEBRADA ARENA
SAN JUAN PR
00926
US

IV. Provider business mailing address

PO BOX 192322
SAN JUAN PR
00919-2322
US

V. Phone/Fax

Practice location:
  • Phone: 787-783-9855
  • Fax: 787-782-7995
Mailing address:
  • Phone: 787-783-9855
  • Fax: 787-782-7995

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MYRTHA I RIVERA
Title or Position: PRESIDENTE
Credential:
Phone: 787-783-9855