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General NPI Number Information
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NPI Number | 1467506766
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Entity Type | Organization
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Legal Business Name | FARMACIA AGUADA INC.
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Dates
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Enumeration Date | 01/23/2007
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Last Update Date | 07/12/2007
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Provider Practice Location Address
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Address Line | CARR. 417 BO. MALPASO
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City | AGUADA
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State | PR
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Zip | 00602
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Country | US
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Telephone | 787-868-6240
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Fax | 787-868-3589
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Provider Business Mailing Address
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Address Line | P.O BOX 991
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City | AGUADA
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State | PR
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Zip | 00602
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Country | US
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Telephone | 787-868-6240
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Fax | 787-868-3589
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Authorized Official
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Title or Position | OWNER
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Name | MR. VICTOR JOSE GARCIA
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Credential |
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Telephone | 787-868-6240
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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 | 07-F-2299
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License Number State | PR
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