Healthcare Provider Details

I. General information

NPI: 1881735520
Provider Name (Legal Business Name): METRO PHARMACY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/08/2007
Last Update Date: 11/16/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

AVE DE DIEGO 371
SAN JUAN PR
00929
US

IV. Provider business mailing address

PO BOX 29025
SAN JUAN PR
00929-0025
US

V. Phone/Fax

Practice location:
  • Phone: 787-767-5100
  • Fax: 787-250-7829
Mailing address:
  • Phone: 787-767-5100
  • Fax: 787-250-7829

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number08-F-2448
License Number StatePR

VIII. Authorized Official

Name: MRS. LUZ G CRUZ
Title or Position: ADMINISTRATOR
Credential:
Phone: 787-780-1964