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General NPI Number Information
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NPI Number | 1265597686
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Entity Type | Organization
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Legal Business Name | SUPER FARMACIA PLAZA
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Dates
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Enumeration Date | 12/26/2006
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Last Update Date | 04/21/2010
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Provider Practice Location Address
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Address Line | 7 CALLE MUNOZ RIVERA
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City | FLORIDA
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State | PR
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Zip | 00650-2033
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Country | US
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Telephone | 787-822-2582
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Fax | 787-822-1546
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Provider Business Mailing Address
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Address Line | PO BOX 436
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City | FLORIDA
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State | PR
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Zip | 00650-0436
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PHARMACIST OWNER
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Name | VIRGILIA PEREZ
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Credential |
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Telephone | 787-822-2582
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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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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 11F0010
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License Number State | PR
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