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General NPI Number Information
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NPI Number | 1346227931
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Entity Type | Organization
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Legal Business Name | FARMACIA HAYDEE
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Dates
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Enumeration Date | 12/27/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3044 AVE JUAN HERNANDEZ ORTIZ
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City | ISABELA
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State | PR
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Zip | 00662-3603
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Country | US
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Telephone | 787-872-5110
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Fax | 787-872-5110
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Provider Business Mailing Address
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Address Line | 3044 AVE JUAN HERNANDEZ ORTIZ P O BOX 547
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City | ISABELA
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State | PR
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Zip | 00662-3603
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Country | US
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Telephone | 787-872-5110
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Fax | 787-872-5110
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Authorized Official
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Title or Position | PHARMACIST/OWNER
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Name | MR. ISMAEL ANTONIO ROSA
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Credential |
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Telephone | 787-872-5110
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 848
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License Number State | PR
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