Healthcare Provider Details

I. General information

NPI: 1154537678
Provider Name (Legal Business Name): ISLA NENA PHARMACY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 CALLE MUNOZ RIVERA
VIEQUES PR
00765-3042
US

IV. Provider business mailing address

PO BOX 1475
VIEQUES PR
00765-1475
US

V. Phone/Fax

Practice location:
  • Phone: 787-741-1906
  • Fax: 787-741-1903
Mailing address:
  • Phone: 787-741-1906
  • Fax: 787-741-1903

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: MS. ELBA LUZ CORREA
Title or Position: PHARMACIST OWNER
Credential: RPH
Phone: 787-741-1906