Healthcare Provider Details

I. General information

NPI: 1962561266
Provider Name (Legal Business Name): METRO PHARMACY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2006
Last Update Date: 11/16/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

AVE ISAAC GONZALEZ
UTUADO PR
00641
US

IV. Provider business mailing address

PO BOX 2087
ARECIBO PR
00613-2087
US

V. Phone/Fax

Practice location:
  • Phone: 787-986-0227
  • Fax: 787-834-9408
Mailing address:
  • Phone: 787-894-1679
  • Fax: 787-894-1608

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number09-F-2509
License Number StatePR

VIII. Authorized Official

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