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General NPI Number Information
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NPI Number | 1457649642
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Entity Type | Organization
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Legal Business Name | FARMACIA LISYAI II
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Dates
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Enumeration Date | 07/21/2011
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Last Update Date | 06/06/2022
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Provider Practice Location Address
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Address Line | CARR 931 INT KM 5.4 BO NAVARRO
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City | GURABO
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State | PR
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Zip | 00778
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Country | US
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Telephone | 787-687-2584
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Fax | 787-743-2537
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Provider Business Mailing Address
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Address Line | PO BOX 1346
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City | GURABO
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State | PR
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Zip | 00778
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Country | US
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Telephone | 939-644-8338
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Fax | 787-737-0793
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Authorized Official
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Title or Position | OWNER
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Name | MR. ANGEL PENA CRUZ
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Credential |
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Telephone | 939-644-8338
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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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