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General NPI Number Information
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NPI Number | 1366866675
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Entity Type | Organization
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Legal Business Name | SAN PEDRO PHARMACY, CORP
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Dates
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Enumeration Date | 02/06/2014
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Last Update Date | 02/06/2014
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Provider Practice Location Address
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Address Line | 7 CALLE MUNOZ RIVERA
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City | GUAYNABO
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State | PR
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Zip | 00969-5705
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Country | US
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Telephone | 787-720-2196
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Fax | 787-287-8169
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Provider Business Mailing Address
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Address Line | 7 CALLE MUNOZ RIVERA
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City | GUAYNABO
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State | PR
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Zip | 00969-5705
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Country | US
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Telephone | 787-720-2196
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Fax | 787-287-8169
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. BRENDA E RIVERA
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Credential | REGISTER PHARMACIST
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Telephone | 787-720-2196
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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 |
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License Number State |
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