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General NPI Number Information
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NPI Number | 1275767444
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Entity Type | Individual
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Provider Name | ERNESTO CABAN PHARMACY TECHNICIAN
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Gender | Male
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Dates
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Enumeration Date | 05/04/2009
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Last Update Date | 05/04/2009
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Provider Practice Location Address
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Address Line | CARR #2 KM 109.9 BO.GALATEO BAJO
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City | ISABELA
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State | PR
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Zip | 00662
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Country | US
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Telephone | 787-872-5943
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Fax |
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Provider Business Mailing Address
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Address Line | 130 CALLE 22 DE JUNIO
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City | MOCA
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State | PR
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Zip | 00676-4241
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Country | US
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Telephone | 787-404-8920
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183700000X
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Taxonomy Name | Pharmacy Technician
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License Number | 3704
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License Number State | PR
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