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General NPI Number Information
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NPI Number | 1215061056
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Entity Type | Organization
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Legal Business Name | DAMAR OF PUERTO RICO SERVICE INC
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Dates
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Enumeration Date | 03/15/2007
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Last Update Date | 02/25/2015
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Provider Practice Location Address
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Address Line | PLAZA DEL MERCADO, RAFAEL HERNANDEZ CALLE VALLEJO, ESQ. PINERO LOTE#23
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City | SAN JUAN
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State | PR
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Zip | 00925
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Country | US
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Telephone | 787-274-0254
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Fax | 787-771-3585
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Provider Business Mailing Address
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Address Line | PO BOX 25130
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City | SAN JUAN
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State | PR
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Zip | 00928-5130
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Country | US
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Telephone | 787-396-8165
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | ALLAN CAO
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Credential | PHARM. D
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Telephone | 786-547-3240
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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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Taxonomy #2
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Taxonomy Code | 3336C0002X
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Taxonomy Name | Clinic Pharmacy
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License Number | 16-F-3244
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License Number State | PR
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