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General NPI Number Information
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NPI Number | 1376676312
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Entity Type | Organization
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Legal Business Name | GONZALEZ JIMENEZ & SONS
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Dates
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Enumeration Date | 03/13/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | CARR 159 KM 84 BO PADILLA
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City | COROZAL
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State | PR
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Zip | 00783-9569
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Country | US
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Telephone | 787-859-7959
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Fax | 787-859-8128
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Provider Business Mailing Address
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Address Line | HC 05 BOX 10126
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City | COROZAL
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State | PR
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Zip | 00783-9569
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Country | US
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Telephone | 787-859-7959
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Fax | 787-859-8128
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Authorized Official
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Title or Position | PHARMACIST PRESIDENT
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Name | MRS. WANDA JIMENEZ
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Credential |
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Telephone | 787-859-7959
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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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