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General NPI Number Information
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NPI Number | 1144323692
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Entity Type | Organization
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Legal Business Name | SALUD INTEGRAL EN LA MONTANA,INC
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Dates
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Enumeration Date | 09/07/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | CARR 152 KM 12 HM 4 BOX 515
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City | NARANJITO
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State | PR
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Zip | 00719-0515
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Country | US
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Telephone | 787-869-5900
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Fax | 787-722-6980
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Provider Business Mailing Address
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Address Line | CARR 813 KM 1.5 HC 71 BOX 1897
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City | NARANJITO
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State | PR
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Zip | 00719-9510
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Country | US
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Telephone | 787-869-5606
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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 | MR. JAVIER MATOS
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Credential |
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Telephone | 787-869-5900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183700000X
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Taxonomy Name | Pharmacy Technician
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License Number | 1544
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License Number State | PR
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