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General NPI Number Information
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NPI Number | 1053648618
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Entity Type | Organization
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Legal Business Name | FARMACIA MEDICAL PLAZA
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Dates
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Enumeration Date | 11/03/2009
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Last Update Date | 11/03/2009
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Provider Practice Location Address
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Address Line | CARRETERA #1 BARRIO TURABO CONSOLIDATED MALL LOCAL C 31C
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City | CAGUAS
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State | PR
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Zip | 00725
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Country | US
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Telephone | 787-286-1694
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Fax |
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Provider Business Mailing Address
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Address Line | HC 8 BOX 39533
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City | CAGUAS
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State | PR
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Zip | 00725-9671
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PHARMACY TECHNICIAN
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Name | DARYLIS PIRIS
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Credential |
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Telephone | 787-286-1694
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 11-F-2774
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License Number State | PR
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