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General NPI Number Information
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NPI Number | 1467469643
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Entity Type | Organization
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Legal Business Name | ISLAND INFUSION PHARMACY
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Dates
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Enumeration Date | 08/01/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 108 CALLE ARZUAGA
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City | SAN JUAN
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State | PR
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Zip | 00925-3718
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Country | US
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Telephone | 787-767-2626
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Fax |
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Provider Business Mailing Address
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Address Line | ST ARZUAGA #108 ESQ. MONSENOR
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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 | 787-767-2626
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | EDGARDO HERNANDEZ
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Credential |
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Telephone | 787-767-2626
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number |
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License Number State |
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