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General NPI Number Information
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NPI Number | 1205983665
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Entity Type | Organization
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Legal Business Name | JUAN E. BERRIOS MARRERO
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Dates
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Enumeration Date | 01/05/2007
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Last Update Date | 07/01/2008
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Provider Practice Location Address
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Address Line | CARR 818 KM 01 BO CIBACO
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City | COROZAL
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State | PR
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Zip | 00783
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Country | US
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Telephone | 787-859-5639
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Fax | 787-859-1620
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Provider Business Mailing Address
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Address Line | PO BOX 814
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City | COROZAL
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State | PR
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Zip | 00783
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Country | US
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Telephone | 787-859-5639
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Fax | 787-859-1620
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Authorized Official
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Title or Position | DUENO FARMACEUTICO
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Name | MRS. JUAN E BERRIOS
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Credential |
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Telephone | 787-859-5639
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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 | 07F1800
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License Number State | PR
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