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General NPI Number Information
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NPI Number | 1366570574
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Entity Type | Organization
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Legal Business Name | FARMACIA HOSPITAL AUXILIO MUTUO
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Dates
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Enumeration Date | 03/01/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | AVE. PONCE DE LEON 715 PDA. 37.5
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City | HATO REY
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State | PR
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Zip | 00919
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Country | US
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Telephone | 787-758-2000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 191227
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City | SAN JUAN
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State | PR
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Zip | 00919-1227
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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 | MANAGER
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Name | ILIA MELENDEZ
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Credential |
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Telephone | 787-758-2000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 07F0327
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License Number State | PR
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