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General NPI Number Information
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NPI Number | 1447829221
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Entity Type | Organization
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Legal Business Name | ODR PHARMACY LLC
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Dates
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Enumeration Date | 06/24/2021
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Last Update Date | 01/03/2022
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Provider Practice Location Address
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Address Line | URB. AMERICA CALLE BARRANQUITAS #520 INTERSECCION MARGINAL, CARR. ESTATAL 181
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City | SAN JUAN
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State | PR
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Zip | 00928
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Country | US
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Telephone | 939-325-4963
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Fax |
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Provider Business Mailing Address
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Address Line | ESTANCIAS DEL REY APARTMENT 612
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City | CAGUAS
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State | PR
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Zip | 00725
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Country | US
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Telephone | 939-325-4963
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Fax |
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Authorized Official
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Title or Position | OWNER/GENERAL MANAGER
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Name | MR. LUIS A ORTIZ RIVERA
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Credential |
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Telephone | 939-325-4963
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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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