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General NPI Number Information
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NPI Number | 1205401064
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Entity Type | Organization
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Legal Business Name | FARMACIA MILLIE LLC
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Dates
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Enumeration Date | 05/24/2021
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Last Update Date | 05/24/2021
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Provider Practice Location Address
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Address Line | 100 CALLE CECILIO URBINA
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City | GUAYNABO
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State | PR
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Zip | 00969
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Country | US
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Telephone | 787-720-6336
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Fax | 787-708-6115
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Provider Business Mailing Address
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Address Line | PO BOX 1818
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City | GUAYNABO
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State | PR
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Zip | 00970-1818
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Country | US
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Telephone | 787-720-6336
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Fax | 787-708-6115
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RAUL JOSE RIVERA BERRIOS
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Credential | PHARMD
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Telephone | 787-720-6336
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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 |
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License Number State |
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