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General NPI Number Information
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NPI Number | 1407241672
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Entity Type | Organization
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Legal Business Name | AL-TEEN,CORP
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Dates
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Enumeration Date | 04/03/2015
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Last Update Date | 04/03/2015
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Provider Practice Location Address
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Address Line | 2021 SABANA SECA
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City | TOA BAJA
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State | PR
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Zip | 00949
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Country | US
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Telephone | 787-929-7505
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Fax |
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Provider Business Mailing Address
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Address Line | 2021 AVE.SABANA SECA
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City | TOA BAJA
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State | PR
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Zip | 00949
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Country | US
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Telephone | 787-929-7505
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Fax | 787-753-6702
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. ABDULLAH A YASSIN
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Credential |
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Telephone | 787-929-7505
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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 | 17-F-3270
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License Number State | PR
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