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General NPI Number Information
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NPI Number | 1275865750
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Entity Type | Organization
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Legal Business Name | PHARMACY EXPRESS
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Dates
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Enumeration Date | 02/08/2010
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Last Update Date | 04/11/2019
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Provider Practice Location Address
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Address Line | CARR #3 KM 24.5 PLAZA RIO GRANDE BO. GUZMAN ABAJO
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City | RIO GRANDE
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State | PR
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Zip | 00745
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Country | US
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Telephone | 787-657-3555
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Fax | 787-657-3550
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Provider Business Mailing Address
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Address Line | P.O. BOX 8578
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City | HUMACAO
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State | PR
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Zip | 00792
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Country | US
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Telephone | 787-657-3555
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Fax | 787-657-3550
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. IZETTE M DEL MORAL
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Credential |
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Telephone | 787-657-3555
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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 | 17-F-2787
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License Number State | PR
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