Healthcare Provider Details

I. General information

NPI: 1790827889
Provider Name (Legal Business Name): A. CORDERO BADILLO ,INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2007
Last Update Date: 07/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

183 SAN LORENZO SHOPPING CENTER
SAN LORENZO PR
00754
US

IV. Provider business mailing address

PO BOX 458
CATANO PR
00963-0458
US

V. Phone/Fax

Practice location:
  • Phone: 787-715-1770
  • Fax: 787-715-1771
Mailing address:
  • Phone: 787-638-8955
  • Fax: 787-715-1771

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: LINNETTE VALLELLANES
Title or Position: PHARMACY DIRECTOR
Credential: RPH
Phone: 787-638-8955