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General NPI Number Information
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NPI Number | 1144241449
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Entity Type | Organization
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Legal Business Name | COOPHARMA INTEGRATED SOLUTION
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Dates
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Enumeration Date | 07/21/2006
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Last Update Date | 08/08/2008
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Provider Practice Location Address
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Address Line | 165 AVE. BO. AMELIA CENTRO CIBERNETICO ZONA LIBRE DE E
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City | GUAYNABO
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State | PR
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Zip | 00968
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Country | US
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Telephone | 939-969-0196
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Fax |
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Provider Business Mailing Address
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Address Line | CARR.165 CENTRO CIBERNETICO ZONA LIBRE DE COMERCIO BO. AMELIA
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City | GUAYNABO
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State | PR
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Zip | 00970
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Country | US
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Telephone | 939-969-0196
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. CARLOS HIRAM CALLAZO
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Credential |
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Telephone | 939-969-0196
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number |
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License Number State |
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