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General NPI Number Information
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NPI Number | 1154308716
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Entity Type | Organization
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Legal Business Name | SAN PEDRITO, LLC
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Dates
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Enumeration Date | 12/26/2005
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Last Update Date | 07/22/2021
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Provider Practice Location Address
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Address Line | VILLA DEL REY 3RA SECC CARR 172 ESQ ASTURIAS
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City | CAGUAS
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State | PR
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Zip | 00725-7113
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Country | US
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Telephone | 787-746-5952
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Fax | 787-744-3397
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Provider Business Mailing Address
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Address Line | PO BOX 5986
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City | CAGUAS
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State | PR
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Zip | 00726-5986
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Country | US
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Telephone | 787-746-5952
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Fax | 787-744-3397
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Authorized Official
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Title or Position | PHARMACIST/ OWNER
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Name | ROBERTO PEIRATAS
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Credential | RPH
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Telephone | 787-746-5952
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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 | 09F0204
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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