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General NPI Number Information
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NPI Number | 1306064191
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Entity Type | Organization
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Legal Business Name | SANTA ANA HOLDINGS GROUP INC
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Dates
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Enumeration Date | 04/24/2007
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Last Update Date | 04/20/2017
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Provider Practice Location Address
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Address Line | 367 CALLE VICTORIA
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City | PONCE
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State | PR
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Zip | 00730-3473
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Country | US
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Telephone | 787-842-2285
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Fax | 787-844-0983
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Provider Business Mailing Address
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Address Line | 367 CALLE VICTORIA
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City | PONCE
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State | PR
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Zip | 00730-3473
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Country | US
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Telephone | 787-842-2285
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Fax | 787-844-0983
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Authorized Official
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Title or Position | OWNER
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Name | JOSE FEBLES SERRANO
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Credential | RPH
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Telephone | 787-842-2285
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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 | 19F1583
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License Number State | PR
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