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General NPI Number Information
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NPI Number | 1184466443
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Entity Type | Organization
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Legal Business Name | PHARMACY VCG, LLC
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Dates
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Enumeration Date | 06/08/2024
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Last Update Date | 06/08/2024
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Provider Practice Location Address
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Address Line | 59 CALLE SAN JOSE E
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City | AIBONITO
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State | PR
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Zip | 00705-3579
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Country | US
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Telephone | 787-502-5723
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 465
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City | AIBONITO
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State | PR
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Zip | 00705-0465
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Country | US
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Telephone | 787-502-5723
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Fax |
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Authorized Official
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Title or Position | PHARMACIST
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Name | DR. GLORIMAR ORTIZ
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Credential | PHARM D
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Telephone | 787-502-5723
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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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