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General NPI Number Information
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NPI Number | 1154458743
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Entity Type | Organization
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Legal Business Name | FARMACIA DON LUIS DE GUAYNABO INC
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Dates
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Enumeration Date | 02/28/2007
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Last Update Date | 04/06/2016
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Provider Practice Location Address
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Address Line | CARR 181 KM 9 1 BO DOS BOCAS
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City | TRUJILLO ALTO
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State | PR
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Zip | 00976
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Country | US
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Telephone | 787-283-1920
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Fax | 787-755-3278
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Provider Business Mailing Address
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Address Line | HC 645 BOX 5198
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City | TRUJILLO ALTO
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State | PR
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Zip | 00976-9759
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Country | US
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Telephone | 787-283-1920
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Fax | 787-755-3278
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Authorized Official
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Title or Position | MANAGER
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Name | RICHARD NEGRIN
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Credential |
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Telephone | 787-383-1926
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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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 | 17F2097
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License Number State | PR
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