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General NPI Number Information
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NPI Number | 1174807416
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Entity Type | Individual
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Provider Name | EDWIN S MERCADO RPH
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Gender | Male
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Dates
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Enumeration Date | 10/05/2011
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Last Update Date | 10/05/2011
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Provider Practice Location Address
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Address Line | WALGREENS ST710 CARR#2 SUITE 01 DRIVE-INN PLAZA
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City | BAYAMON
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State | PR
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Zip | 00961
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Country | US
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Telephone | 787-785-9191
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Fax | 787-785-9223
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Provider Business Mailing Address
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Address Line | PMB 235 CALLE 39 UU1 SANTA JUANITA
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City | BAYAMON
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State | PR
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Zip | 00956
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Country | US
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Telephone | 787-785-9191
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Fax | 787-785-9223
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 3945
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License Number State | PR
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