Healthcare Provider Details

I. General information

NPI: 1467495846
Provider Name (Legal Business Name): ONE STOP PRESCRIPTION EL MONTE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/14/2006
Last Update Date: 04/26/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

114 AVE DE DIEGO
SANTURCE PR
00907-2345
US

IV. Provider business mailing address

10 AVE SIMON MADERA PARCELAS FALU
SAN JUAN PR
00924-2231
US

V. Phone/Fax

Practice location:
  • Phone: 787-977-2007
  • Fax: 787-977-2016
Mailing address:
  • Phone: 787-751-9606
  • Fax: 787-751-0286

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number18F2841
License Number StatePR

VIII. Authorized Official

Name: PEDRO VANGAFELICIANO
Title or Position: PRESIDENT
Credential:
Phone: 787-751-9606