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General NPI Number Information
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NPI Number | 1417210667
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Entity Type | Individual
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Provider Name | SANDRA RIVERA
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Gender | Female
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Dates
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Enumeration Date | 06/22/2012
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Last Update Date | 06/22/2012
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Provider Practice Location Address
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Address Line | WALGREENS DRIVE IN PLAZA CARR 2 # 2135 SUITE 1
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City | BAYAMON
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State | PR
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Zip | 00959
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Country | US
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Telephone | 787-785-9176
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Fax | 787-785-9223
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Provider Business Mailing Address
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Address Line | URB.ROSE VALLEY CALLE ROSE # 67 CALLE ROSE # 67
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City | MOROVIS
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State | PR
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Zip | 00687
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Country | US
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Telephone | 787-565-5086
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Fax | 787-785-9223
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183700000X
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Taxonomy Name | Pharmacy Technician
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License Number | 3929
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License Number State | PR
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